Audiological Testing
Why Is a Hearing Test Included in a Balance Assessment?
When investigating dizziness and balance problems, it is important to assess the hearing system too, as both organs share the same space and fluids inside the body.
By combining audiological and vestibular testing, clinicians can build a much clearer picture of how your inner ears are functioning, and what could be causing your symptoms.
Why Are Hearing and Balance Connected?
The hearing organ (cochlea) and the balance organs (vestibular system) are located together within the inner ear.
They:
Share the same blood supply
Share the same fluid-filled system
Are connected by the vestibulocochlear nerve (the eighth cranial nerve)
Because of this close relationship, diseases affecting one part of the inner ear often affect the other.
What Does an Audiological Assessment Involve?
Our hearing assessment usually includes:
Pure Tone Audiometry
This measures the quietest sounds you can hear across a range of pitches. You will wear headphones and press a button to indicate whenever you hear a tone.
Each ear is tested separately to identify:
Normal hearing
Hearing loss
Differences between the ears
Patterns that may suggest specific inner ear conditions
Extended High-Frequency Audiometry
Where clinically appropriate, we also assess hearing beyond the standard range, up to 16,000 Hz (16 kHz).
This can help detect subtle changes to the cochlear that may not appear on conventional hearing tests, and is particularly useful in patients with tinnitus, noise exposure or suspected early inner ear damage.
Tympanometry
Tympanometry assesses how well your middle ear is functioning. A soft probe is placed in the ear canal while gentle changes in air pressure are introduced.
The test measures how freely your eardrum moves and helps identify problems such as:
Eustachian tube dysfunction
Middle ear fluid (glue ear)
Tympanic membrane perforations
Reduced eardrum mobility
Excessively mobile eardrums
This information is important because middle ear problems can influence both hearing and certain vestibular tests.
Why Is Hearing Important When Investigating Dizziness?
The pattern of hearing loss, or even normal hearing, can provide valuable diagnostic information.
For example:
Ménière's Disease - Often causes fluctuating hearing loss, tinnitus, ear fullness and episodes of vertigo.
Vestibular Schwannoma (Acoustic Neuroma) - May cause hearing loss in one ear together with tinnitus and imbalance.
Labyrinthitis - Can affect both hearing and balance because both structures are involved in the inflammatory process.
Superior Semicircular Canal Dehiscence (SSCD) - Some patients experience hearing symptoms alongside dizziness triggered by loud sounds or pressure changes.
Can Hearing Be Normal Even If I Have a Balance Problem?
Yes. Many vestibular disorders do not affect hearing.
Conditions such as:
Normal hearing can therefore be just as diagnostically valuable as an abnormal result.
Is the Assessment Painful?
No. Both hearing tests and tympanometry are quick, comfortable and non-invasive.
During tympanometry you may notice a brief feeling of pressure in your ear, similar to travelling on an aeroplane, but this lasts only a few seconds.
What Other Tests May Be Performed?
Depending on your symptoms, your hearing assessment may be combined with:
Caloric testing
Computerised Dynamic Posturography
Positional testing for BPPV
Each investigation assesses a different part of the balance system, allowing us to identify the underlying cause of your symptoms as accurately as possible.
What Happens After the Assessment?
Your clinician will explain your hearing results alongside the findings of your vestibular tests.
Together, these results help determine whether your symptoms are most likely caused by:
An inner ear disorder
A balance nerve problem
A central (brain related) condition
A vestibular migraine
PPPD
Another cause of dizziness
If further investigations or referral to an ENT consultant or another specialist are needed, these will be discussed with you.
How Can Northern Balance Clinic Help?
At Northern Balance Clinic, our vestibular assessments include comprehensive audiological testing where appropriate, allowing us to evaluate both hearing and balance together.
By combining hearing tests with advanced vestibular investigations, we can help diagnose conditions including:
Ménière's disease
Vestibular neuritis
Labyrinthitis
Vestibular schwannoma
Benign Paroxysmal Positional Vertigo (BPPV)
Vestibular migraine
Persistent Postural-Perceptual Dizziness (PPPD)
Superior Semicircular Canal Dehiscence (SSCD)
Bilateral vestibular loss
Our goal is to identify the true cause of your symptoms and guide you towards the most appropriate treatment.
Book a Comprehensive Vestibular Assessment
If you are experiencing dizziness, vertigo, imbalance, tinnitus or hearing changes, our specialist clinicians can perform a comprehensive hearing and balance assessment to help identify the underlying cause of your symptoms.
Ready to take the next step?
If you’d like help to get your balance problems resolved, get in touch and we’ll guide you through the process, from arranging an appointment to a friendly introductory phone call with one of our specialists.