How is a hearing test performed? How much does it cost? Is it necessary to have the test done at a hospital?

How is a hearing test performed? How much does it cost? Is it necessary to have the test done at a hospital?

• 24 February, 2026
• Written by Digibionic Malaysia

We Digibionic often receives inquiries from hearing aid subsidy applicants: What does a hearing test involve? Is it expensive? Can it only be done at a hospital? Therefore, we are providing a detailed explanation to help everyone fully understand our hearing test services!

Hearing Test	Main purpose	Key points
Pure tone audiometry	Measuring hearing thresholds at different frequencies	The most common hearing test that can help generate an audiogram to determine the degree of hearing loss.
Speech hearing test	Assess speech comprehension and recognition abilities	Through single-word or sentence tests, assess the patient’s speech discrimination ability in noisy or quiet environments.
Tympanogram examination	Check the condition of the middle ear and the movement of the tympanic membrane.	It can determine whether there are middle ear diseases such as middle ear effusion or Eustachian tube dysfunction.
Electrophysiological examination	Assess inner ear and auditory nerve function	Commonly used for infants, young children, or individuals unable to cooperate with behavioral tests, such as ABR and ASSR tests.

Examination principle:
By using sounds of various frequencies, decibels and the patient’s feedback, hence the degree of hearing loss at different frequencies is confirmed.

Test types:
Hearing tests are classified into “air conduction” and “bone conduction” based on the sound conduction path.

Testing tools:
The patient must wear over-ear headphones or bone conduction headphones and hold a feedback button (or have no button and use “raising hand” as feedback).

Examination Procedure:
1. Our Audiologist will examine the ear canal with an otoscope to understand its health condition and inquire about medical history.
2. The patient will enter the audiometry room and the testing method will be explained.
3. After our Audiologist puts on over-ear headphones for the patient, they will leave the audiometry room, close the door, and isolate external noise.
4. Air conduction hearing test:
>>4-1. The Audiologist will operate the machine outside the window to emit sounds of different frequencies and decibels. If the patient hears them, they need to press a button or raise their hand to provide feedback.
>>4-2. The test time is approximately 10 minutes.
>>4-3. Our Audiologist will enter the audiometry room, change the examinee’s headphones to bone conduction headphones, and then leave the audiometry room, closing the door.
5. Bone conduction hearing test:
>>5-1. Our Audiologist will repeat the air conduction audiometry test’s step outside the window. After approximately 5 minutes, the tests for the left and right ears will be completed.
>>5-2. Our Audiologist enters the audiometry room and leads the patient out.
6. Begin explaining the patient’s audiogram and analyzing their current hearing status.

Test results:
An audiogram will be printed out after the test is finished. An audiogram is a graph that records the corresponding changes in auditory response and decibel value. An example is shown below:

Test principle:
By identifying vowels of varying volumes, this test assesses the ease with which our patient can conduct during their daily communication. This test can also be performed while wearing a hearing aid to determine if the aid is adequately helpful. This test is also known as a speech effectiveness or speech discrimination test.

Examination Procedure:
1. Our Audiologist will say a series of words or questions to the patient, who will then be asked to repeat them or select relevant pictures and answer the questions.
2. The entire test takes approximately 5 minutes, and the left and right ears must be tested alternately.

Examination Results:

SRT: The minimum decibel threshold at which the patient can hear.
MCL: The most comfortable volume for the patient to listen.
SD: There’s a score (out of 100%) its for speech discrimination . It simulates the best possible outcome for the customer when wearing hearing aids during doing tests with MCL volume

Additional Information:
1. Hearing aid stores generally conduct speech hearing tests, but this is for reference when selecting hearing aids and is not applicable for applying for hearing aid subsidies.
2. SD scores usually improve significantly after wearing hearing aids. However, due to the lack of standard norms and critical difference (confidence interval) values, it is recommended that the SD score be greater than 20% of the original test value after wearing hearing aids to confirm significant benefit.

Examination principle:
A normal eardrum has the function of deforming to balance the air pressure inside and outside the ear. This test is to confirm whether there are any abnormalities in the outer and middle ear; if there are abnormalities, it indicates that there is disease or aging in the eardrum or middle ear. This test is also known as the tympanogram test or tympanometry test.

Inspection tool:

Examination Procedure:
1. Our Audiologist changes the earplug on the acoustic impedance meter according to the size of the patient’s ear canal, and then inserts the instrument into the patient’s ear canal.
2. The acoustic impedance meter will apply different air pressures and detect changes in the eardrum. During the test, patient may feel swelling in the ear canal and experience slight sounds, which are normal.
3. The entire test takes about 3 minutes, and the left and right ears must be tested alternately.

Examination results:
The tympanogram——is a diagram that records the corresponding changes in the eardrum’s deformability (middle ear compressive stress) and pressure. The following are five common cases.

Type A: This is a normal tympanic cavity pattern. However, if a disease affects the middle ear’s ability to receive sound waves (such as early-stage otitis media), the patient may still have a Type A pattern even if their hearing is abnormal.

Type As: This indicates that the highest auditory compressibility is lower than normal, which means that the auditory energy resistance is higher. It is commonly seen in patients with poor stapes mobility, scar tissue on the eardrum, or external otitis.

Type Ad: This type shows abnormally high middle ear compressive stress, commonly seen in patients with conditions such as “loose or perforated eardrum, or fractured ossicles”.

Type B: The graph is close to a straight line, indicating that the highest auditory energy stress has not been stimulated. The most common cause is middle ear effusion, which prevents the eardrum from vibrating effectively.

Type C: This refers to middle ear pressure less than atmospheric pressure, with the highest hearing capacity at negative pressure, around -100 daPa. It is commonly seen in the early or recovery phase of otitis media, that is, before middle ear effusion forms or when the effusion is being absorbed, or when Eustachian tube function is low, resulting in a closed or incompletely open Eustachian tube (Murphy, 1979).

Test principle:
When the senses are stimulated, they send nerve signals to the brain to form a sensation. This test uses this physiological characteristic to detect the auditory nervous system of the patient and record the potential response on the nerve pathway to estimate the minimum hearing threshold and the integrity of the auditory nerve.

Test types:
There are two categories: “Auditory Brainstem Response” and “Auditory Steady-State Evoked Response”—the testing methods are largely the same, but the Auditory Brainstem Response primarily tests the integrity of the auditory nerve pathway, and its results are closer to the average hearing threshold of 2000 to 4000 Hz (Hertz) on the behavioral hearing test report chart. The “Auditory Steady-State Evoked Response” mainly assesses mid- and low-frequency and profound hearing loss, supplementing the former’s limitations.
The Auditory Brainstem Response emits two types of test sounds: a wide-frequency range (e.g., ticking) and a specific frequency range (e.g., plosives). The stimulus sound used in the Auditory Steady-State Evoked Response is induced by a pure tone with amplitude modulation or frequency modulation; when the stimulation rate of this stimulus sound is sufficient to cause a brief overlap of response potentials, the response potential is generated.

Examination Procedure:
1. Have the patient lie flat and clean the keratinized area along the midline of the forehead and behind the ears (mastoid process) to reduce detection impedance.
2. The operator applies electrode wires to the subject and guides the subject to relax, even to the point of falling asleep.
3. The operator controls the machine to emit test sounds, which are recorded and fed back by the machine.
4. The overall testing time varies depending on the items being tested and the subject’s stability. It can be as short as 30 minutes; if frequency division testing is required, it may take 1-2 hours.

If you are purchasing a hearing aid, you can simply visit a regular hearing aid retailer for a free hearing test. This service typically includes otoscopy, pure-tone audiometry, and speech audiometry.

※ As there is no uniform fee standard among hearing aid, the actual cost will be based on the quote from the hearing aid center itself.

Q: Which department should I go to for a hearing test at the hospital?
A: The ENT department! Did you guess right?

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