Hearing Loss

Diagnosis & Tests

The first step in having your hearing evaluated is telling your healthcare provider that you have a hearing problem. Don’t be embarrassed. Hearing loss is very common, and there are effective treatments available. 

The important thing is getting it diagnosed as soon as possible. This helps prevent other physical and emotional effects such as depression and social isolation. In fact, older adults should have their hearing checked every year, just like vision testing. Screening for hearing impairment is part of the Medicare annual wellness exam. 

Physical Examination

Your healthcare provider will examine your ear canal for wax, foreign material, inflammation, or other causes of conductive hearing loss and remove any wax or other debris. If you feel you have a hearing loss or if it has gotten worse, you may be referred to an otolaryngologist (ear, nose, throat doctor) for further evaluation. You may also be referred to an audiologist for a hearing test and possible treatment. Medicare covers payment for an audiologic examination if it is ordered by a physician.

Audiometric Testing

Most hearing problems are diagnosed by audiologists, who are healthcare professionals trained in hearing and balance issues. Most can also help select and fit hearing aids and hearing assistance technologies. They can also determine if you are a candidate for a cochlear implant, which is surgically implanted. Individuals with severe to profound hearing loss are considered possible candidates for a cochlear implant. Audiologists conduct audiometric testing to determine how much hearing you’ve lost. Such testing can also provide clues about the causes of your hearing loss.

The gold standard test is pure-tone audiometry. The test is simple and painless: you wear earphones and listen to pure tones at different pitches and volumes sent to one or both ears, letting the audiologist know when you can no longer hear the tone. 

The audiologist will also test your ability to understand speech in quiet and in adverse listening situations and assess your middle ear to determine if there are any abnormalities, including excessive fluid build-up or negative pressure.

Your primary healthcare provider or audiologist may also ask you to complete a questionnaire designed to measure your communication ability in various settings. These sets of questions can help measure your perception of the impact that hearing loss has on your daily activities. Your responses can also suggest if you are a candidate for some form of non-medical intervention to promote hearing and understanding.


Last Updated June 2020