What Happens in a Hearing Test? Audiometry Explained
What a hearing test involves, how long it takes, what pure-tone audiometry and tympanometry measure, and how to read your audiogram results.
People often put off a hearing test because they are not sure what it involves. It is one of the simplest assessments in healthcare: nothing enters your ear painfully, nothing is injected, and you will have your results the same day. Here is exactly what happens.
Step 1 — History and ear examination
We start by asking where you struggle to hear, whether one ear is worse, whether you have tinnitus, dizziness, pain or discharge, your noise exposure history, and relevant medical history such as diabetes or medications. Then we look inside your ears with an otoscope. This alone identifies earwax blockage, perforations and infections — a meaningful share of hearing complaints stop here, because the fix is removing wax rather than buying a device.
Step 2 — Pure-tone audiometry
This is the core test. You wear headphones, and tones are played at different pitches (frequencies) and volumes in one ear at a time. You signal each time you hear a tone, however faint. The quietest level you can reliably detect at each frequency is your threshold, and plotting those thresholds produces your audiogram. It usually takes 15 to 20 minutes.
Bone conduction testing
A small vibrating device placed behind the ear sends sound directly to the inner ear, bypassing the ear canal and middle ear. Comparing this with the headphone results tells us where the problem sits — a conductive loss in the outer or middle ear (often treatable) or a sensorineural loss in the inner ear (usually managed with hearing aids).
Step 3 — Speech testing
Hearing tones is not the same as understanding words. We check the quietest level at which you can repeat words correctly, and how clearly you understand speech when it is loud enough. This predicts how much benefit you will get from hearing aids better than the audiogram alone does.
Step 4 — Tympanometry (when needed)
A soft probe gently changes air pressure in the ear canal to measure how well the eardrum moves. It detects fluid behind the eardrum, eustachian tube problems and perforations. You feel a light pressure change, similar to an aeroplane descending. It takes under a minute per ear.
How to read your audiogram
The horizontal axis is pitch, from low frequencies on the left to high frequencies on the right. The vertical axis is loudness in decibels hearing level (dB HL), with quiet at the top. Your marks sit where you first heard each tone — so the lower on the chart your line sits, the more hearing loss you have. Right ear is conventionally marked with circles in red, left ear with crosses in blue.
| Threshold (dB HL) | Degree | What it means day to day |
|---|---|---|
| -10 to 25 | Normal | No difficulty in ordinary conversation |
| 26 to 40 | Mild | Struggles with soft speech and noisy rooms |
| 41 to 55 | Moderate | Frequent difficulty with normal conversation |
| 56 to 70 | Moderately severe | Most conversation is hard without help |
| 71 to 90 | Severe | Only loud speech is heard; hearing aids needed |
| 91+ | Profound | Powerful aids or cochlear implant assessment |
Most age-related loss shows as a line that starts near normal on the left and slopes downwards to the right — high frequencies go first. That is precisely why speech sounds present but unclear: vowels are low-pitched and still audible, while the consonants that carry meaning are high-pitched and are the ones being lost.
Getting a hearing test at home in Lahore
We bring the equipment to you. Home testing removes the transport problem for elderly and less mobile patients, and it has a genuine clinical advantage: we assess your hearing in the room where you actually live and can set the device up against your own TV and your own family's voices. If the environment is too noisy for reliable measurement on the day, we will tell you rather than record an unreliable result.