Comprehensive Hearing Evaluation

We conduct a number of different tests that together provide a full picture of how your ear is functioning, how you are hearing, and if a hearing loss may be present.


An otoscope is an instrument used to examine the ear canal and health of the tympanic membrane (eardrum). This is done at the beginning of the appointment to examine the ear.

Immittance Testing

Immittance Testing - Hearing Evaluation

Tympanometry – this test measures how your tympanic membrane (eardrum) is moving. We need to make sure that the eardrum is moving appropriately to ensure that sound is being efficiently transferred to your inner ear.

Acoustic Reflexes – this test measures how your middle ear responds to a brief, high-intensity sound. The response provides information about the status of your inner ear and part of the central auditory nervous system.

Acoustic Decay – this test allows us to determine the status of the stapedial reflex by seeing how long the reflex can be sustained.

Otoacoustic Emissions

(OAEs) – OAEs is the response generated by the outer hair cells (OHCs) in the inner ear. This response tells us whether the OHCs are functioning as they should for hearing.

Pure Tones

For this evaluation, you will be in a soundproof booth and have headphones on. Different frequencies (pitches) will be presented at different intensities (volume) to determine the softest level that you can hear in the speech frequencies of 250 – 8000 Hz. This part of the test is evaluating the overall function of your auditory system. Next, a different type of headset will be used to evaluate how you hear when you bypass the middle ear. The new headset will sit behind your ear on your mastoid. This part of the test is evaluating how your inner ear and nerves are functioning, independently from the middle and outer ear systems.

Speech Testing

There are two different speech tests completed under the headphones in the soundproof booth. The first test is called the Speech Recognition Threshold Test. This test consists of two-syllable words called spondees. The words are first presented at a normal level and then decreased to determine the softest level that the patient is able to repeat the word back. The second test completed is the Word Recognition Score Test. This test is presented at a level comfortable for the patient. This test determines how well the patient’s word recognition is when speech is at the most comfortable level.