Hearing tests measure how well you are able to hear. Normal hearing happens when sound waves travel into your ear, causing your eardrum to vibrate. The vibration moves the waves farther into the ear, where it triggers nerve cells to send sound information to your brain. This information is translated into the sounds you hear.

Hearing loss happens when there is a problem with one or more parts of the ear, the nerves inside the ear, or the part of the brain that controls hearing. There are three main types of hearing loss:

• Sensorineurual (also called nerve deafness). This type of hearing loss is caused by a problem with the structure of the ear and/or with the nerves that control hearing. It may be present at birth or show up late in life. Sensorineural hearing loss is usually permanent. This type of hearing loss ranges from mild (the inability to hear certain sounds) to profound (the inability to hear any sounds).
• Conductive. This type of hearing loss is caused by a blockage of sound transmission into the ear. It can occur at any age, but it's most common in infants and young children and is often caused by ear infections or fluid in the ears. Conductive hearing loss is usually mild, temporary, and treatable.
• Mixed, a combination of both sensorineural and conductive hearing loss.

Hearing loss is common in older adults. About one-third of adults over the age of 65 have some hearing loss, most often the sensorineural type. If you are diagnosed with hearing loss, there are steps you can take that may help treat or manage the condition.

Hearing tests are used to find out whether or not you have a hearing problem and, if so, how serious it is.

You may need a hearing test if you have symptoms of hearing loss. These include:

• Trouble understanding what other people are saying, especially in a noisy environment
• Needing to ask people to repeat themselves
• Trouble hearing high-pitched sounds
• Needing to turn up the volume on the TV or music player
• A ringing sound in your ears

Your hearing test may be done by a primary health care provider or one of the following types of providers:

• An audiologist, a health care provider who specializes in diagnosing, treating, and managing hearing loss
• An otolaryngologist (ENT), a doctor specializing in treating diseases and conditions of the ears, nose, and throat.

There are several types of hearing tests. Most tests check for your response to tones or words delivered at different pitches, volumes, and/or noise environments. These are called sound tests. Common sound tests include:

Acoustic Reflex Measures, also called middle ear muscle reflex (MEMR), test how well the ear responds to loud sounds. In normal hearing, a tiny muscle inside the ear tightens when you hear loud noises. This is called the acoustic reflex. It happens without you knowing it. During the test:

• The audiologist or other provider will place a soft rubber tip inside the ear.
• A series of loud sounds will be sent through the tips and recorded onto a machine.
• The machine will show when or if the sound has triggered a reflex.
• If hearing loss is bad, the sound may have to be very loud to trigger a reflex, or it may not trigger the reflex at all.

Pure-tone test, also known as audiometry. During this test:

• You will put on headphones.
• A series of tones will be sent to your headphones.
• The audiologist or other provider will change the pitch and loudness of the tones at different points during the test. At some points, the tones may be barely audible.
• The provider will ask you to respond whenever you hear the tones. Your response may be to raise your hand or press a button.
• The test helps find the quietest sounds you can hear at different pitches.

Tuning fork tests. A tuning fork is a two-pronged metal device that makes a tone when it vibrates. During the test:

• The audiologist or other provider will place the tuning fork behind your ear or on top of your head.
• The provider will hit the fork so that it makes a tone.
• You'll be asked to tell the provider whenever you hear the tone at different volumes, or if you heard the sound in your left ear, right ear, or both equally.
• Depending on where the fork is placed and how you respond, the test can show if there is hearing loss in one or both ears. It can also show which type of hearing loss you have (conductive or sensorineural).

Speech and word recognition tests can show how well you can hear spoken language. During the test:

• You will put on headphones.
• The audiologist will talk to you through your headphones, and ask you to repeat a series of simple words, spoken at different volumes.
• The provider will record the softest speech you are able to hear.
• Some of the testing may be done in a noisy environment, because many people with hearing loss have trouble understanding speech in loud places.

Another type test, called tympanometry, checks for how well your eardrum moves.

During a tympanometry test:

• The audiologist or other provider will place a small device inside the ear canal.
• The device will push air into the ear, making the eardrum move back and forth.
• A machine records the movement on graphs called tympanograms.
• The test helps find out if there is an ear infection or other problems such as fluid or wax buildup, or a hole or tear in the eardrum.

You don't need any special preparations for a hearing test.

There is no risk to having a hearing test.

Your results may show if you have a hearing loss, and whether the hearing loss is sensorineural or conductive.

If you are diagnosed with sensorineural hearing loss, your results may show that the hearing loss is:

• Mild: you can't hear certain sounds, such as tones that are too high or too low.
• Moderate: you can't hear many sounds, such as speech in a noisy environment.
• Severe: you can't hear most sounds.
• Profound: you can't hear any sounds.

Treatment and management of sensorineural hearing loss will depend on serious it is.

If you are diagnosed with conductive hearing loss, your provider may recommend medicine or surgery, depending on the cause of the loss.

If you have questions about the results, talk to your health care provider.

Even mild hearing loss can make it difficult to understand normal speech. Because of this, many older adults will avoid social situations, leading to isolation and depression. Treating hearing loss can help prevent these problems. While hearing loss in older adults is usually permanent, there are ways to manage the condition. Treatment options include:

• Hearing aids. A hearing aid is a device that's worn either behind or inside the ear. A hearing aid amplifies (makes louder) sound. Some hearing aids have more advanced functions. Your audiologist can recommend the best option for you.
• Cochlear implants. This is a device that's implanted surgically in the ear. It's usually used in people with more severe hearing loss and who don't get much benefit from using a hearing aid. Cochlear implants send sound directly to the hearing nerve.
• Surgery. Some types of hearing loss can be treated with surgery. These include problems with the eardrum or in the tiny bones inside the ear.