If you concerned about the possibility of hearing loss you’ve probably scheduled a hearing test with an audiologist. On the day of your appointment, here is what you can expect.

Health history

The audiologist will start by asking about your general health history. The audiologist isn’t being nosy or just making conversation. They need to know about your history of ear infections, other diseases that can cause hearing loss and any history you have with ototoxic drugs. It’s a good idea to make a list of medications before you go and jot down key illnesses or head injuries. It will make this part of the appointment go smoother.

Visual exam of your ears

The audiologist will use an otoscope to examine your ears. This is to check for any obstruction like impacted earwax. The visual exam is used to determine if there is a medical reason for hearing loss. Conductive hearing loss is caused by problems with sound making it from the outer ear to the middle ear.

Acoustic reflex measure

This test is used to determine if the muscles in the middle ear are functioning properly. It evaluates the level of sound at which a muscle in the middle ear contracts in response to noise. The audiologist uses this test to help determine if this is a cause of conductive hearing loss.

Tympanometry

This is another middle ear test. If you have a history of ear infections, you may have damage to the eardrum (tympanic membrane). Air is blown into the ear canal to make the eardrum vibrate. Tympanometry can determine if there is fluid in the ear or a perforation in the eardrum. This is another test for conductive hearing loss.

Static acoustic impedance

The audiologist uses this test to determine the volume of air in the ear canal. It is used to identify damage in the middle ear and is a test of conductive hearing loss.

Pure-tone testing

Once medical reasons for conductive hearing loss are ruled out, the audiologist will begin testing for sensorineural hearing loss. Pure-tone testing will determine your hearing threshold. For this simple test, you will listen for different tones at different frequencies and respond as directed.

Speech recognition threshold

The pure-tone test detects your hearing threshold for pure tones. The speech recognition threshold test is used to confirm the pure-tone test. Because speech isn’t made up of pure tones, this test is used to determine the softest level of speech you can hear half the time. It is performed with background noise and in silence to replicate normal conversation situations.

Audiogram interpretation

The results of the tests will be recorded on an audiogram and tympanogram. Once all tests are completed, the audiologist will interpret the results for you. Based on the results, assistive hearing devices such as hearing aids may be prescribed. If hearing aids are necessary, the audiologist will order the devices and schedule an appointment for a hearing aid fitting.