The Adult Diagnostics Audiology Department at the Royal National ENT and Eastman Dental Hospitals offers a comprehensive range of auditory (hearing) assessments to facilitate accurate clinical diagnoses for various hearing-related conditions.
This page is designed for patients scheduled to attend our department. It outlines the various tests that may be conducted during your appointment.
Before you attend for your hearing assessment
Your GP should have checked that your ears are clear and healthy before referring you. It is important to ensure that your ears are clear of wax before attending your appointment as this can affect test results and we may not be able to proceed with the assessment.
If you have not recently had your ears examined, we kindly ask that you visit your GP prior to your appointment to ensure your ears are free of wax.
If you already wear hearing aids or have previously worn hearing aids, please bring them and any glasses you require to your appointment.
We encourage you to bring a family member, friend, or carer to your appointment for support.
We can arrange interpreters for all languages, including British Sign Language (BSL).
During the appointment
Please be aware that we are a teaching department, and we would appreciate the co-operation of patients in supporting our students in their training. Please let the audiologist know if you are uncomfortable with a student being present and we will try to accommodate accordingly.
Each assessment will be fully explained to you by the audiologist to ensure you understand, and to give you an opportunity to ask questions.
Initially the audiologist will discuss any hearing difficulties, take a brief audiology history, and examine your ears using an otoscope to check that your ears are healthy and free from wax.
The full range of hearing assessments
Please note it may not be necessary to conduct every listed assessment. The audiologist will determine which tests are most appropriate for you during your appointment
Duration: 15-30 minutes
Purpose:
A hearing test is a personalised and accurate assessment of your hearing levels.
Procedure:
The audiologist will place headphones over your ears and present various tones. You will be given a hand-held button, which you will be asked to press each time you hear the sounds. The audiologist will record your responses.
A small oscillator is often placed behind one of your ears and the process is repeated. In some cases, you may be asked to ignore any additional sounds - a rushing noise - but continue to press for the tones.
Figure 1. A Bone Conductor is placed on the Bone Behind the Ear
Duration: 5-10 minutes
Purpose:
This test is used alongside the PTA to build a more detailed picture of your hearing.
Tympanometry is a diagnostic test that assesses the function of the middle ear by measuring the movement of the eardrum (tympanic membrane) in response to changes in air pressure. It is commonly used to identify middle ear conditions such as a build-up of fluid, Eustachian tube dysfunction, or perforations in the eardrum.
Process:
A small soft probe is gently placed at the entrance to your ear canal and a quick and automatic pressure recording is made.
Duration: 5-10 minutes
Purpose:
This assessment is used to ensure that the Eustachian tube is functioning properly.
Process:
Following tympanometry testing (above) you will be instructed to hold your nose and blow to ‘pop’ your ears - a 2nd pressure reading will be taken (Valsalva).
You will then be instructed to hold your nose and swallow to manipulate the pressure in your ears - a 3rd pressure reading will be taken (Toynbee).
Duration: 20 minutes
Purpose:
Acoustic reflex testing is a quick and painless diagnostic test that measures how the middle ear muscles react to sounds of varying intensities.
The test helps to determine the integrity of the auditory pathway from the ear to the brainstem, as well as to identify possible disorders related to the middle ear, cochlea, or auditory nerve.
Process:
A small soft probe is gently placed at the entrance to your ear canal and sounds are transmitted through it. The equipment automatically displays the results.
Duration: 10-20 minutes
Purpose:
This is a non-invasive procedure used to assess the function of the outer hair cells in the cochlea, specifically to evaluate cochlear (sensory) hearing. It is typically used to screen for hearing loss and to monitor cochlear function in adults.
Process:
A small soft probe is gently placed at the entrance to your ear canal. You will hear clicks and humming sounds. You will need to stay still and remain quiet. The equipment automatically displays the recordings.
Duration: 30 minutes
Purpose:
The ABR test measures how well sound signals travel through the ear to the midbrain. It helps check the health of your hearing system, including the inner ear, hearing nerve, and brainstem. The test procedure is non-intrusive and will cause you no discomfort.
Process:
You will be asked to lie on a couch. The audiologist will clean your skin with a wipe and scrub and four small sensors will be attached on your head and ears. Headphones will then be placed over your ears, and you will hear clicking and rushing sounds. You do not need to respond to these sounds; you will be asked to remain still and relax. The computer automatically records your responses.
Duration: 30 minutes
Purpose:
Speech audiometry is a test that checks how well you can hear and understand speech. It helps us learn more about how your hearing works in daily life. The test measures the softest level at which you can recognise speech (Speech Recognition Threshold, SRT), how clearly you can understand words (speech discrimination), and how hearing loss might affect your ability to communicate in everyday situations.
Process:
Headphones will be placed over your ears, and you will be asked to listen to a series of words and repeat back what you hear. The audiologist will record your responses throughout the assessment.
Duration: 60 minutes
Purpose:
Cortical Evoked Potential (CEP) Audiometry is a safe and non-invasive test that checks how your brain processes sound. It helps us understand how well your hearing pathways are working.
Process:
The audiologist will clean your skin with a wipe and scrub and four small sensors will be attached on your head and ears. Headphones will then be placed over your ears, and you will hear a series of repetitive tone bursts. You do not need to respond to these sounds, the computer automatically records your responses.
During the test it is important to stay awake and alert, it would be useful to bring a book, tablet, or something quiet to watch or read while the test is performed.
- British Academy of Audiology
- Tinnitus UK (formerly the British Tinnitus Association)
- Hearing Link
- The Hyperacusis Network
- Royal National Institute for Deaf People (RNID)
- UCL Ear Institute
- NHS
- University College London Hospitals
- Address: 235 Euston Road, London NW11 2BU
- Telephone: 020 3456 7890
UCLH cannot accept responsibility for information provided by other organisations.
We would be happy to answer any questions you have.
Telephone: 020 3456 5164
Switchboard: 020 3456 7890
Email: uclh.
Website: www.
Patient Advise and Liaison Service (PALS)
PALS is a patient-centred accessible service designed to provide a dedicated point of contact for patients, their families, and carers. If you are facing a concern or issue that you have been unable to resolve, PALS is here to offer support and assistance in finding a solution.
The PAL'S office is in the main atrium of University College Hospitals
235 Euston Road
PALS are open:
Monday to Friday: 10:00 am – 16:00 pm
Telephone: 020 3447 3042
Email: uclh.
Royal National ENT & Eastman Dental Hospital, 47-49 Huntley Street, London WC1E 6DG
Huntley Street is close to Euston, Warren Street and Goodge Street underground stations and there are bus stops nearby.
Page last updated: 05 February 2025
Review due: 01 February 2027