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Hearing loss assessment, audiology-led workup with tympanometry, acoustic reflex and consultant ENT.

A structured hearing-loss assessment: full audiometry, tympanometry, acoustic reflex threshold, otoscopy and consultant ENT review. Investigates sensorineural, conductive and mixed hearing loss - with fast-track hearing-aid and cochlear-implant referral where indicated.

An audiologist performing a hearing loss assessment in a private London clinic

Key facts

  • Definition

    Comprehensive audiology and ENT hearing-loss assessment.

  • Same-day tests

    Audiometry, tympanometry and acoustic reflex threshold.

  • ENT review

    Consultant ENT review, same visit where indicated.

  • Imaging

    MRI IAM for asymmetric sensorineural hearing loss.

  • Onward pathway

    Hearing-aid fitting or cochlear-implant assessment.

  • Integrated

    Combined with vestibular assessment when needed.

Indicative pricing

What a private hearing loss assessment costs in London.

Indicative ranges across UK private providers.

In short

£180–£320, with findings the same day.

Assessment type Indicative range
Standard hearing-loss assessment (audiology only) £180–£320
Audiology + consultant ENT review £350–£600
Sudden SNHL urgent slot (ENT + audiology) £450–£800
Hearing loss + vestibular assessment £550–£950
MRI IAM (asymmetric SNHL work-up) £450–£800
Cochlear-implant candidacy assessment £600–£1,200

Prices vary by clinic, whether a consultant ENT review is included, and whether a vestibular battery or MRI IAM is added.

The problem

A hearing loss assessment is only as good as the person putting it together.

The audiogram is the answer - and how it is interpreted alongside tympanometry, acoustic reflexes and the ENT examination decides the plan. We route you to a consultant ENT surgeon and a full audiology battery in one visit.

  • Asymmetric or one-sided loss?

    We add tympanometry, ART and MRI IAM to exclude vestibular schwannoma.

  • Time for a hearing aid?

    A structured audiology assessment, real-ear-measurement fitting and a trial.

Preparation and diagnosis

The steps of a full hearing loss assessment.

Each test answers a specific question - together they separate cochlear from retrocochlear, and conductive from sensorineural.

  1. 01

    Step

    ENT consultation

    History and examination by a consultant ENT surgeon - noise, ototoxic drugs, family history, red flags.

  2. 02

    Step

    Otoscopy

    Direct visualisation of the canal and tympanic membrane - wax, effusion, perforation, cholesteatoma.

  3. 03

    Step

    Pure-tone audiometry

    Air and bone conduction across 250 Hz–8 kHz to characterise sensorineural, conductive or mixed loss.

  4. 04

    Step

    Tympanometry

    Middle-ear pressure and compliance - flat tracings in effusion, high peaks in ossicular disruption.

  5. 05

    Step

    Acoustic reflex threshold

    Stapedial reflex testing - an objective cross-check that separates cochlear from retrocochlear disease.

  6. 06

    Step

    Speech-in-noise test

    Real-world discrimination score - often more revealing than the pure-tone graph in early presbycusis.

  7. 07

    Step

    Written report and plan

    A structured report with hearing-aid, MRI IAM, cochlear-implant or ENT surgical pathway as indicated.

What it shows

When a hearing loss assessment is the right test.

The assessment answers a specific set of questions - the type, severity and side of hearing loss, and whether imaging is needed. These are the presentations we see most.

  • Sensorineural hearing loss

    Age-related, noise-induced or genetic - the audiogram characterises pattern and severity.

  • Conductive hearing loss

    Otosclerosis, middle-ear effusion, ossicular disruption - bone–air gap on audiometry.

  • Mixed hearing loss

    A sensorineural component with an added conductive gap - both compartments involved.

  • Asymmetric SNHL

    One-sided loss raises a retrocochlear differential - MRI IAM to exclude vestibular schwannoma.

  • Sudden SNHL

    A sudden drop in hearing is an ENT emergency - steroids within 72 hours materially change outcome.

  • Noise-induced dips

    The classic 4 kHz notch after occupational or recreational noise exposure.

  • Age-related presbycusis

    Bilateral high-frequency loss with speech-in-noise difficulty - the commonest adult pattern.

  • Red flag: asymmetric SNHL - MRI IAM to exclude vestibular schwannoma

    One-sided sensorineural loss always earns cross-sectional imaging.

Treatment and next steps

What happens after the assessment.

The audiogram is a starting point. This is the range of onward pathways your report can point to.

  • Hearing-aid trial and fitting

    Real-ear-measurement fitting by an audiologist, with a structured trial period.

  • Cochlear implant assessment

    Candidacy work-up when hearing aids no longer give adequate speech discrimination.

  • Middle-ear surgery

    Grommet insertion, tympanoplasty or ossiculoplasty for conductive loss where indicated.

  • Stapedectomy for otosclerosis

    Consultant otology referral for surgical management of otosclerotic conductive loss.

  • Steroids for sudden SNHL

    Oral or intratympanic steroids within the 72-hour window for sudden sensorineural loss.

  • MRI IAM for asymmetric loss

    Dedicated internal auditory meatus MRI to exclude vestibular schwannoma.

  • Tinnitus management

    Sound therapy, hearing-aid masking and CBT-based tinnitus retraining where relevant.

  • Structured ENT follow-up

    Serial audiometry and consultant review to track progression and adjust the plan.

Safety and eligibility

One of the safest assessments in medicine.

A hearing loss assessment is exceptionally safe - the practical points are when a private slot is right, when A&E is right, and where the assessment’s limits are.

  • Painless, radiation-free

    Audiometry, tympanometry and ART use sound and air pressure - no needles, no radiation.

  • Sound-treated booth

    Testing is done in a calibrated audiology booth - the standard of care for pure-tone thresholds.

  • No preparation

    No fasting, no drug-hold. Take medication as normal and bring any hearing aids you use.

  • Sudden SNHL is time-critical

    A sudden drop in hearing is a same-week ENT case - steroids within 72 hours matter.

  • Tinnitus caveat

    Tinnitus without hearing loss rarely needs urgent imaging, but always earns an audiogram.

  • A normal audiogram is not a full clear

    Hidden hearing loss and central auditory processing disorders can sit behind normal thresholds.

  • MRI IAM sometimes follow-on

    Asymmetric SNHL or unilateral tinnitus with hearing loss earns dedicated MRI of the internal auditory meatus.

  • Bring prior audiograms

    Comparison against previous audiograms sharpens the pattern and rate-of-change assessment.

  • Vestibular schwannoma is uncommon

    Rare, but consistent asymmetric SNHL is the presentation - imaging is a reassurance step, not a scare.

Red flags - investigate promptly

  • Asymmetric sensorineural hearing loss
  • Sudden sensorineural hearing loss
  • Bilateral rapidly progressive sensorineural loss
  • Ototoxic drug exposure (e.g. cisplatin, aminoglycosides)
  • Post-meningitis hearing loss
  • Autoimmune inner-ear disease
  • Post-radiotherapy hearing loss
  • Suspected vestibular schwannoma
  • Congenital or childhood-onset hearing loss

Reading your report

An audiology report can look intimidating. It isn’t.

Whatever the finding, the report keeps to the same four parts.

A consultant ENT surgeon reviewing an audiogram and tympanogram on a clinical workstation at a UK private clinic

A quiet reminder

The report is written for your doctor, not for you - and that’s normal.

If you would like us to talk you through it before your follow-up, just ask.

  1. 01 Header

    Indication and risk factors

    Your details, the reason for the assessment, and the exposures that shape interpretation.

  2. 02 Technique

    Tests performed and calibration

    Audiometry, tympanometry, ART and speech-in-noise - with the equipment and standards used.

  3. 03 Findings

    Audiogram pattern, tympanogram, ART

    Threshold-by-threshold description, tympanogram type, reflex results and discrimination scores.

  4. 04 Impression

    The conclusion: read this first

    The type and severity of loss, and the concrete next step - hearing aid, MRI IAM, ENT surgery or follow-up.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Frequently asked

Everything we get asked about hearing loss assessments.

Quick answers on cost, referrals, sudden SNHL, when an MRI IAM is needed, and what happens next.

  • What does a hearing loss assessment show?

    The type and severity of your hearing loss - sensorineural, conductive or mixed - along with middle-ear function, acoustic reflexes and how well you discriminate speech in noise. It is the structured workup that turns "I can’t hear" into a specific diagnosis and a plan.

  • How long does a hearing loss assessment take?

    A standard audiology-only assessment is around 60 minutes. Audiology plus a consultant ENT review is around 75–90 minutes. A combined hearing-and-balance assessment is a half-day.

  • Do I need a referral?

    Most clinics accept self-referral for a hearing loss assessment.

  • When is an MRI needed?

    Asymmetric sensorineural hearing loss, unilateral tinnitus with hearing loss, or a discrepancy between the audiogram and acoustic reflexes earns an MRI of the internal auditory meatus to exclude vestibular schwannoma.

  • I had a sudden drop in hearing - is this urgent?

    Yes. Sudden sensorineural hearing loss is an ENT emergency. Oral or intratympanic steroids within 72 hours materially change the recovery odds.

  • When should I see a GP urgently instead?

    Sudden hearing loss with vertigo, facial weakness or neurological symptoms is a 999 call. Sudden hearing loss alone is a same-day ENT case. Gradual loss is a booked assessment.

Sources

Guidelines this page draws on.

Reviewed by Pulse Atlas Editorial Board, . Published 2026-07-30. Next review 2027-07-30. Reading time ~6 min.

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In practice, in London

Getting hearing loss assessment sorted in London, without the guesswork

With hearing loss assessment, the London question is usually about report turnaround and the radiologist reading it - not whether the scan is available. Public provision for hearing loss assessment is competent but constrained by capacity. Private London clinics tend to have shorter diaries and longer appointment slots, so you get the same specialists with more time. For people who’ve been going round in circles with primary care, that first proper conversation is often what shifts things.

A private hearing loss assessment pathway in London usually looks like this: an initial consultation, any diagnostics booked at a nearby facility (most within Zone 1 or 2), and a written report sent to you and your GP within a few days. The consultants we work with hold NHS posts alongside their private lists, which keeps the standards consistent across both settings. For hearing loss assessment specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.

Honesty about expectations is part of the job. A private hearing loss assessment appointment in London won’t change the underlying medicine - the guidelines, the consultants, and the equipment are largely the same as on the NHS. What it changes is speed, continuity, and the amount of time you get to actually talk through the findings. Everyone we route to is GMC-registered and works within CQC-regulated facilities.