A complete diagnostic hearing evaluation is the foundation of every other service we offer. It tells us exactly which frequencies your ear has lost, how well you understand speech in different conditions, whether your middle ear is functioning normally, and whether anything medical needs follow-up. The whole evaluation takes 60–90 minutes and is more comfortable than most patients expect.
What’s Included
Case-history conversation
We start with a real conversation — not a clipboard. Dr. Rossetti asks about the situations where hearing feels difficult, your medical history, noise exposure, family history of hearing loss, medications, and your goals if any treatment is needed. This shapes which testing makes sense and how to interpret the results.
Otoscopic exam
A gentle, illuminated look inside both ear canals to check for earwax, inflammation, fluid, drainage, perforation, or anything else that might affect testing or warrant medical referral. Painless, takes about a minute.
Pure-tone audiometry
The classic “press the button when you hear a tone” test, performed in our sound-treated booth. We test both ears separately across the full speech-relevant frequency range (250 Hz through 8000 Hz, sometimes higher). The result is your audiogram — a chart showing exactly which pitches and volumes you can hear.
Bone-conduction testing
A small bone-conduction headband bypasses the outer and middle ear and stimulates the inner ear directly. Comparing your air-conduction results to bone-conduction results tells us whether your hearing loss is conductive (something blocking the sound), sensorineural (inner-ear or nerve damage), or mixed.
Speech testing
We test how well you can recognize and repeat common words at conversational levels, then in background noise. This is often the most clinically meaningful part of the evaluation because it reflects real-world communication ability — not just whether you can hear tones.
Tympanometry
A quick measurement of how well your eardrum and middle-ear bones are moving. Painless — a small probe creates gentle pressure changes in your ear canal. Useful for diagnosing fluid, eardrum perforation, eustachian tube dysfunction, and otosclerosis.
Acoustic reflex testing
Measures the involuntary muscle reflex of the middle ear in response to loud sound. Helps localize where in the auditory pathway any problem is occurring.
Reading Your Audiogram
Your audiogram is a chart with frequency on the horizontal axis (low pitches on the left, high pitches on the right) and loudness on the vertical axis (zero at top, loudest at bottom). The circles and X’s plotted on the chart show the softest sound you can hear at each frequency in each ear.
Hearing in the “normal” range falls in the top portion of the chart (0–25 dB). Anything plotted below that represents some degree of hearing loss:
- Mild (26–40 dB): Difficulty hearing soft speech, especially in noise
- Moderate (41–55 dB): Difficulty hearing normal conversational speech
- Moderately severe (56–70 dB): Difficulty hearing even loud conversation
- Severe (71–90 dB): Most conversational speech inaudible without amplification
- Profound (91+ dB): Hearing only the loudest sounds
Most adult hearing loss starts in the high frequencies (right side of the chart) and progresses gradually. That’s why patients often say they can hear their spouse but can’t make out the words — consonants like “s,” “t,” “f,” and “th” live in the high frequencies and are crucial for word clarity.
Dr. Rossetti walks you through your audiogram in plain language at the end of every evaluation. You leave knowing what your hearing looks like and what (if anything) it suggests for next steps.
What Happens After the Evaluation
Outcomes vary by patient. Common paths after a hearing evaluation:
- Clean results. Many patients have hearing within the normal range and simply need a baseline for the future. We schedule a follow-up in 1–3 years.
- Treatable conductive issue. If we find earwax, fluid, or a middle-ear issue, we treat it directly or refer appropriately. Often hearing improves dramatically afterward.
- Mild hearing loss, watch and wait. Mild changes that don’t yet warrant treatment but should be monitored annually.
- Hearing aid candidate. If treatment is appropriate, we discuss the right form factor and technology level for your specific lifestyle. See our Hearing Aids overview →
- Medical referral. If the evaluation suggests something that warrants ENT or other medical follow-up, we coordinate the referral.
How Often Should You Be Tested?
- Adults under 50 with no concerns: Once as a baseline, then as concerns arise
- Adults 50–65: Every 1–3 years
- Adults 65+: Annually, especially if cognitive concerns are present (untreated hearing loss is linked to faster cognitive decline)
- Anyone with significant noise exposure: Annually, regardless of age
- Existing hearing aid users: Every 6–12 months for adjustments and re-testing