Hearing Problems Center

Hearing Loss Diagnosis

Hearing loss may have an easily treated underlying cause such as wax build-up. However, only a doctor can diagnose the cause of a hearing loss. If you notice a change in hearing, see your doctor, even if you are at an age at when hearing loss might be expected. But who should you see? When it comes to diagnosing and treating ear problems, doctors basically have three levels of "ear expertise." Each has their own niche.

  1. Medical doctors or Primary care physicians (MD/PCP) - Often your first contact is with a standard MD, also called a General Practitioner (GP) or family doctor. These doctors have no specialized training in treating ear problems. However, you often need to see this primary doctors in order to get a referral to an ear specialist such as an ENT or otologist.
  2. Ears, nose & throat doctors (ENT) - ENTs are medical doctors that have taken further training and specialized in problems of the ears, nose and throat. ENTs generally specialize in problems of the middle ear-typically middle ear infections and medical problems of the middle ear. 
  3. Otologists or Neurotologists - Otologists and neurotologists are medical doctors who have trained as ENTs and then completed additional studies is the sub-specialty of otology (or neurotology). These are the real ear experts and are the doctors that know the most about inner ear problems and are usually are the only doctors that seem to recognize the true emergency nature of sudden hearing loss.

Medical exams
A doctor will first review your medical history and then examine your ears. At first, your doctor may perform a general screening test to get an overall idea of how well you can hear. Your doctor may ask you to cover one ear at a time to see how well you hear words spoken at various volumes and how you respond to other sounds.

You may next be referred to an audiologist for a series of specialized tests to determine the ability to hear and the extent of hearing loss. These tests usually occur in a soundproof room and aim to distinguish the difference between conductive and neurosensory hearing losses. Other tests may also be performed. From the results of these tests, the doctor will be able to diagnose the cause of your hearing loss. Tests for hearing loss include:

Audiologic assessment - A basic hearing test shows how well you can hear sounds of different levels and frequencies. The test also shows your ability to recognize words at different sound levels.

Auditory brainstem response (ABR) - The ABR test measures how well auditory nerves transmit signals from the inner ear to the brain, where the signals are interpreted. Electrodes are placed behind the earlobes and on the forehead. You then listen through earphones for sounds.

Computerized tomography (CT) scan - A CT scan is an X-ray pictures of the temporal bones at the base of the skull which protect the organs that control your hearing and balance.

Electrocochleography (ECoG) - The ECoG test measures activity in the inner ear. During the test, electrodes are placed behind the earlobes, on the forehead and in the ear canal. You will then listen through earphones for sounds.

Otoacoustic emissions (OAE) - This test measures sounds that the ear produces when tiny hair cells on the cochlea are stimulated. A probe with a sound-generating loudspeaker is placed in the ear canal. A microphone in the probe captures the sounds emitted from the cochlea. Low levels of otoacoustic emissions indicate hearing loss.

Newborn hearing screening - Hearing specialists use physical and behavioral tests to screen newborns for hearing loss.  If a newborn fails the initial screening, follow-up tests are ordered.

Your medical history, specialized audio test results, and your doctor's opinion will all be used in order to determine the degree of hearing loss and its cause.  Once you have been diagnosed, you can begin treatment.  The goals of treatment are many.  Read our How to Treat Hearing Loss section now to learn more about treatments for hearing loss.

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