If you've been noticing that conversations are harder to follow, or that you're frequently asking people to repeat themselves, a comprehensive hearing evaluation is the right first step. Here's exactly what to expect when you come in for a hearing evaluation at our Manhattan audiology practice, and why the process matters for getting the right outcome.
Before the Testing Begins
When you arrive, you'll complete intake forms covering your personal and medical history, and your insurance information. Before any testing starts, your audiologist will sit down with you to understand where you're experiencing difficulty — whether that's hearing in noisy restaurants, on the phone, or in quiet one-on-one conversations. This context shapes how we interpret your results.
Otoscopy: A Look Inside Your Ears
The exam begins with otoscopy — a visual inspection of your ear canal and eardrum using a small instrument called an otoscope. This step checks for earwax buildup, fluid, perforation of the eardrum, or other physical factors that could affect your hearing. It's quick and painless, and it tells us whether the ear canal is clear before proceeding with acoustic testing.
Pure-Tone Testing
Pure-tone audiometry is the core of a hearing evaluation. You'll sit in a soundproof booth wearing headphones connected to an audiometer. Tones at different frequencies and volumes are delivered to each ear individually, and you'll indicate each time you hear a sound. This maps out your hearing thresholds — the softest sounds you can detect — across the speech frequency range.
The results are plotted on an audiogram, which gives us a clear picture of the degree and pattern of any hearing loss. We'll walk you through what the audiogram shows, including the type of hearing loss and which frequency ranges are affected.
Speech Testing
Pure-tone results alone don't tell the whole story. Speech testing measures how well you can detect and understand spoken words at different volumes. You'll be asked to repeat back single and two-syllable words, and we may also conduct a speech-in-noise test to evaluate how well you follow conversation in a realistic, noisier environment. This is often where people with hearing loss notice the most difficulty in daily life.
Tympanometry and Acoustic Reflex Testing
Tympanometry checks the mobility of your eardrum by sending a small puff of air into the ear canal and measuring how the eardrum responds. This helps identify fluid in the middle ear, earwax impaction, or a perforated eardrum. The acoustic reflex test measures the involuntary contraction of a small middle ear muscle in response to loud sound, giving additional information about the type and location of hearing loss.
What About ABR Testing?
For patients who have difficulty understanding speech despite relatively normal hearing thresholds, or for those who cannot participate in standard testing, Auditory Brainstem Response (ABR) testing may be recommended. ABR measures the electrical activity along the auditory pathway from the inner ear to the brain and can be performed even when a patient cannot respond behaviorally — making it particularly useful for infants and young children.
Why a Comprehensive Evaluation Matters
Online hearing screeners and quick in-store checks are not a substitute for a full audiological evaluation. They typically measure only basic pure-tone thresholds, leaving out speech testing, middle ear function, and the clinical interpretation that ties everything together. A full evaluation by a licensed audiologist gives you a complete, accurate picture of your hearing — and that accuracy matters directly if hearing aids are recommended.
Schedule a Hearing Evaluation at Our Manhattan Practice
A comprehensive hearing evaluation typically takes about an hour. At the end of your appointment, we'll review all your results with you and discuss next steps — whether that's monitoring your hearing, exploring hearing aid options, or a referral if needed.
Our practice is located at 161 Madison Avenue in Manhattan, one block east of the Empire State Building. To schedule a hearing evaluation with Dr. Ike Iheagwara, contact us at 212-920-1970 or reach out through our website. Getting a clear picture of your hearing is a straightforward process, and it's the foundation for everything that comes after.
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