Hearing Exams: Preparing for Better Auditory Health

By Barry Keate
Barry Keate, has lived with tinnitus over 40 years and has published 150+ research articles on numerous aspects of tinnitus. He is an expert on the condition and a well-known advocate for those with tinnitus.

Hearing Exams: Preparing for Better Auditory Health


Do you lean forward during conversations because voices sound muffled? Do you read lips to fill the gaps or ask people to repeat themselves often? Have you noticed a change in what sounds you can hear easily, or perhaps you’re hearing sounds that aren’t there, like a ringing in your ears?

You’re not alone. Hearing changes with age, noise exposure, and exposure to certain chemicals and medications. Hearing tests should be a part of an annual checkup. However, many fear the stigma associated with hearing loss or losing control. They fear they’ll need bulky and embarrassing hearing aids or never hear the same again. So, even though they have hearing changes, people may avoid hearing tests.

The truth is, the sooner you get a diagnosis and intervention (if necessary), the better the outcome. Delaying your hearing test could pose significant risks to your overall physical and mental health and result in permanent hearing loss. If your doctor does recommend hearing aids, there are many discrete options hardly noticeable to others around you. Hopefully, this guide will help you feel more comfortable taking the next step toward long-term auditory health.

What To Expect

Hearing tests are nothing to fear. Before scheduling a hearing test, your doctor will look in your ears to rule out the following:

  • Obstruction: Sometimes, hearing loss is as simple as an overabundance of ear wax trapped in the ear canal. Your doctor will look in your ear to verify your ear canal is open. They should have a clear and unobstructed view of a healthy eardrum.
  • Infection: Sometimes, hearing loss is due to fluid buildup or infection in the ear. A visual inspection will help your physician detect these so they can prescribe antibiotics or allergy medications. Young people often are fitted for ear tubes that allow them to drain if they have frequent ear infections.
  • Perforation: After exposure to sudden explosive sound waves, head injury, or an untreated infection, you can get a tear in the membrane we call an eardrum. Your doctor may prescribe antibiotic ear drops during healing, but most perforations heal independently in a few weeks. If they don’t, the procedure to patch the hole is quick and safe.

With these underlying conditions eliminated, an audiologist can run further tests.

  • Range: Your inner ear works like a piano. Each frequency or note makes a different nerve twitch and sends a signal to the brain that we interpret as sound. Children, whose ears are as close to perfect as we can get, are better able to hear higher frequencies than adults. As we age, those higher notes get more challenging to hear. Some people lose lower notes first. Explosive noise can damage the nerves for all frequencies.The hearing test first determines which frequencies you can hear. They will put you in a sound booth with tiny earplugs with affixed microphones. It cuts out ambient noise, so you can only listen to what they pipe into you. Then, they have you speak or raise a hand when you hear beeps at various frequencies and volumes until they find your range.
  • Speech: Next, they see if there are words you can’t distinguish because of the inflection, background noise, or direction. Sometimes, you hear better out of one ear than the other.
  • Bone: As you know, sound enters through your ear canal. You may not know that some sounds vibrate through the bones of your head and jaw. They put a headset on you to see if your skull transmits those sounds normally.

That’s it. The computer spits out a report, which the audiologist reads. You’re all set if you’re in the normal range for your age group. If you need medical intervention, they can review options with you, and together, you’ll devise a treatment plan.


For the most accurate results, there are a few things you can do to prepare for your appointment.

  • Noise – Loud noise can temporarily worsen your hearing and skew your results. Avoid concerts, heavy machinery, and other loud noises for the 12 hours before your test.
  • Notes – In the weeks before your appointment, note times you struggle to hear.
    • Was there too much background noise?
    • Do you hear higher or lower notes most clearly?
    • Are you reading lips?
    • Did you have ringing, rushing, or buzzing in your ears lasting more than a few minutes?
    • What happened before the sound? (Tinnitus from loud noise is common but should dissipate quickly.)
    • Did anything make it worse or better? (Tinnitus due to stress is also common.)
  • Wax – Drip warm water, saline, or over-the-counter hydrogen peroxide in your ear with your head tilted for several minutes, then turn over and let your ear drain onto a paper towel or washcloth. It should remove excess earwax. (Note: Peroxide makes bubbles, so you’ll hear a popping sound, and it tickles, but it isn’t harmful.)
  • Meds: Vitamin deficiencies and some medications can cause tinnitus. Your audiologist needs to see the whole picture, so bring a list with meds and supplements, dosage amounts, and frequency. There are supplements for tinnitus relief, vitamins, and herbs.

Even if you need interventions like hearing aids, they are way more effective and discreet than they used to be. It is always better to go sooner rather than later. Some hearing loss is reversible if treated in time.