Free-field audiometry: what to know

You sit in a quiet room facing one or more speakers and respond when you hear tones or speech. The clinician changes the loudness and pitch to identify the softest sounds you can detect in that room. Because both ears receive the sound, the result reflects hearing with the better-performing ear and any contribution from hearing devices. It is useful when headphones are unsuitable, including for some young children, but it does not show which ear is responsible for a difference. Earwax buildup, middle-ear problems and inner-ear disorders can affect hearing.

Bring hearing aids, glasses and any previous hearing results, and tell the clinician about tinnitus, dizziness, ear pain, discharge or recent noise exposure. Follow instructions about using hearing devices during the assessment. If the free-field result suggests reduced hearing, the next step may be a standard hearing test with ear-specific measurements, ear examination or referral to an audiologist or ear specialist. Avoid inserting cotton buds or objects into the ear canal.

Seek prompt medical assessment for sudden hearing loss, severe spinning dizziness, new facial weakness, a severe headache, ear discharge after injury or intense ear pain. Do not wait for a routine hearing screen when hearing changes abruptly. A gradual change, persistent tinnitus or recurrent imbalance also deserves an appointment so the cause can be examined.

Ask whether the result reflects both ears together, whether headphones or bone-conduction testing is needed, and whether earwax or another treatable problem could be contributing. Clarify how hearing should be protected at work, during travel and around loud music.