Hearing and balance assessment (Audiovestibular assessment)

A specialist set of usually not painful tests, led by an audiovestibular doctor or audiologist, that measure how well you hear and how well your inner-ear balance organs are working, to find the cause of hearing loss, tinnitus, dizziness or unsteadiness.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

These are usually not painful, non-invasive tests that measure your hearing and balance to help find the cause of symptoms — they do not treat anything by themselves.
A result guides management and is read alongside your symptoms and examination; it rarely gives a complete diagnosis on its own.
A hearing test takes about half an hour to an hour; full balance testing can take up to about two hours and may make you briefly dizzy.
Sudden hearing loss or sudden severe vertigo needs urgent assessment, not a routine booked test.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeSpecialist hearing and balance tests (non-invasive)

AnaestheticNot needed

How long it takesHearing tests take about 30 to 60 minutes; full balance testing can take up to about 2 hours

Hospital stayOutpatient — no hospital stay

Time off workUsually none, though balance testing can leave you briefly dizzy

When you'll see resultsSome results are explained on the day; detailed balance findings are reported and discussed at a follow-up

On the NHS?Available on the NHS through audiology and audiovestibular medicine services; private testing may be used for speed or choice

A general guide. Your specialist will give you advice for your situation.

Best fit

Measures the type and degree of any hearing loss

Pause if

Sudden hearing loss or sudden severe vertigo needs urgent assessment, not a routine booked test.

Main recovery point

Hearing tests are comfortable. Balance tests, especially the caloric part with warm and cool air or water, can make you feel dizzy or sick for a short...

Good aftercare

A clear, plain-English explanation of the results and what they mean.

During the tests

Hearing tests are comfortable. Balance tests, especially the caloric part with warm and cool air or water, can...

Straight after

Any dizziness from balance testing usually settles within minutes to a short while. You may prefer not to drive...

Same day

Some results, such as your audiogram, are often explained on the day. You can usually return to normal activities...

Following weeks

More detailed balance results are reported and discussed with the specialist at a follow-up appointment, where the...

Medical line illustration of vestibular balance testing for Hearing and balance assessment. — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is a hearing and balance assessment?

A hearing and balance assessment is a group of usually not painful tests that measure two things: how well you hear, and how well the balance organs in your inner ears are working. It is used to find the cause of hearing loss, ringing in the ears (tinnitus), dizziness, vertigo (a spinning feeling) or unsteadiness.

The tests are carried out by audiologists, often working with a doctor in audiovestibular medicine — a specialty focused on hearing and balance disorders that works alongside audiology and ENT. Most tests are non-invasive and comfortable; for example, listening for quiet tones, or having gentle warm and cool air or water in the ear while a camera records your eye movements.

These tests provide information; they do not treat anything by themselves. They can show the type and degree of hearing loss, or point to where a balance problem is coming from. A normal result is reassuring but does not always rule out every cause, and a result usually guides what to do next rather than giving a complete diagnosis on its own.

The findings help you and your specialist decide on the next step, which might be hearing aids, balance physiotherapy, treatment of an underlying condition, further tests such as a scan, or simply reassurance.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Pure tone audiometry

You wear headphones and press a button when you hear quiet beeps at different pitches. The quietest sounds you can hear are plotted on a chart called an audiogram, showing the type and degree of any hearing loss.

Middle-ear tests (tympanometry and reflexes)

A soft probe gently changes the pressure in your ear canal to check how the eardrum and middle ear are working, and can measure the ear's reflex to loud sound. Useful for fluid, infection or eardrum problems.

Speech testing

You repeat words or sentences, sometimes with background noise, to measure how well you understand speech, not just detect sound.

Balance tests (VNG and caloric testing)

You wear goggles with cameras that record your eye movements while you follow targets, change position, and have warm and cool air or water gently placed in each ear. This checks how the balance organs respond and can make you briefly dizzy.

Other specialist balance tests

Depending on your symptoms, tests such as VEMP (using sound and a sensor on the neck) or the video head impulse test may be added to look more closely at specific parts of the balance system.

Hearing test vs balance testing

	Hearing test	Balance testing
Main purpose	Measure hearing	Find cause of dizziness
Typical time	About 30–60 min	Up to about 2 hours
What you feel	Listen and respond	May feel briefly dizzy
Recovery	None	Usually none; brief dizziness possible

You may have one or both, depending on your symptoms. Your specialist will explain which tests you need.

Preparing for your test

Ask whether you are having a hearing test, balance tests, or both, as balance testing takes longer.
Keep your ears free of anything blocking them; tell the team if you think you have a lot of earwax, as it can affect tests.
For balance testing, you may be asked to avoid alcohol and to pause certain medicines (such as some travel-sickness, antihistamine or sedative medicines) for a day or two first — follow the exact advice you are given.
Avoid eye make-up on the day of balance testing, because the cameras track your eyes.
Wear comfortable clothing and bring your glasses if you wear them.
Arrange a lift if you are having balance tests that might leave you dizzy, and ask whether you should avoid driving straight afterwards.
Bring a list of your medicines and a note of your symptoms — when they happen, how long they last and what triggers them.

What happens

For a hearing test, you sit in a quiet room and wear headphones. You press a button or raise a hand when you hear beeps at different pitches and volumes, and you may repeat words for the speech test. A soft probe may briefly change the pressure in your ear for the middle-ear test. None of this hurts.

For balance testing, you usually wear goggles fitted with cameras. The audiologist records your eye movements while you follow moving targets, change head and body positions, and have gentle warm and cool air or water placed in each ear in turn. This part can make you feel dizzy or sick for a short time, which is expected and settles within minutes.

The team talks you through each step. Some findings, such as your audiogram, can be explained on the day; more detailed balance results are often written up and discussed with an audiovestibular specialist at a follow-up appointment, alongside your history and examination.

Is this test right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

Sudden hearing loss or sudden severe vertigo needs urgent assessment, not a routine booked test.
Some balance tests cannot be done, or need adapting, with a perforated eardrum, recent ear surgery or certain ear conditions.
A booked test is the wrong step if your symptoms suggest a stroke or other emergency — that needs immediate care.
Testing is unlikely to help if the cause is already clear and the result would not change your treatment.

Delay or rearrange if…

You have a heavy cold, ear infection or a lot of earwax that could affect the results.
You have not been able to follow advice to avoid alcohol or certain medicines before balance testing.
Your symptoms have suddenly changed or worsened and need urgent review first.
You are unwell or unable to cooperate with the tests on the day.

Alternatives to discuss

An ear examination and simpler bedside balance checks by a clinician first.
Watchful waiting if symptoms are mild and settling.
Treating an obvious cause, such as earwax or an ear infection, before formal testing.
Imaging, such as an MRI scan, where a structural cause is suspected.
Referral to a different specialist if the cause is likely to lie outside the ear.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Benefits

Measures the type and degree of any hearing loss
Helps find the cause of dizziness, vertigo or unsteadiness
Guides the next step, such as hearing aids, balance physiotherapy or further tests
Can reassure you when the result is normal
Provides a baseline to compare against in future if symptoms change
Helps decide whether a scan or onward referral is needed

Risks & complications

More common

Temporary dizziness or nausea during and shortly after caloric balance testing
Mild tiredness from concentrating during the tests
The inconvenience of a long appointment, especially for full balance testing
Sometimes needing further or repeat tests if results are unclear

Less common

A result that is normal but does not fully explain your symptoms
A result that picks up something unexpected, leading to more tests
Brief discomfort from water or air in the ear

Rare but serious

Dizziness that lasts longer than usual after balance testing
Tests being unsuitable or having to stop, for example with a perforated eardrum or certain ear conditions

These tests are usually not painful and carry very little risk; the main thing to expect is short-lived dizziness during balance testing. The more important issue is interpreting the results: a normal test does not always rule out every cause, and a result usually guides management rather than giving a diagnosis on its own. Ask what each test can and cannot show, and what the plan is if the result is normal, abnormal or unclear.

Published figures to discuss

These are low-risk tests, so meaningful complication rates are not the issue. What matters more is test accuracy: hearing and balance tests can occasionally be normal despite real symptoms, or pick up findings that turn out not to explain the problem. A result guides management and is interpreted alongside your symptoms and examination, not in isolation, and sometimes needs repeating.

Figure	Reported range	How to interpret it	Source / confidence
No single test explains every dizziness symptom	Core limitation	Inner-ear, migraine, blood pressure, neurological, anxiety and medication causes can overlap.	Guide sourcesClinical context
Temporary dizziness from vestibular tests	Common with some tests	Caloric, positional and head-movement tests can provoke symptoms briefly.	Guide sourcesClinical context
False reassurance from normal tests	Recognised	Some vestibular disorders fluctuate, compensate over time or need testing during an attack.	Guide sourcesClinical context
Urgent red flags missed	Avoidable safety risk	Sudden hearing loss, facial weakness, stroke symptoms, severe new headache or persistent neurological signs need urgent medical review.	NHS — Hearing testsnhs.ukSource-linked context

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is usually no physical recovery from hearing and balance tests. After balance testing you may feel dizzy or off-balance for a short time, so it is worth planning for that. Some results are explained on the day, while others are reported and discussed at a follow-up.

During the tests

Hearing tests are comfortable. Balance tests, especially the caloric part with warm and cool air or water, can make you feel dizzy or sick for a short time.

Straight after

Any dizziness from balance testing usually settles within minutes to a short while. You may prefer not to drive immediately if you feel unsteady.

Same day

Some results, such as your audiogram, are often explained on the day. You can usually return to normal activities once any dizziness has passed.

Following weeks

More detailed balance results are reported and discussed with the specialist at a follow-up appointment, where the next steps are agreed.

What's normal — and not a worry

Feeling briefly dizzy or queasy after balance testing, which settles
Mild tiredness after concentrating during a long appointment
No physical after-effects from a hearing test
Waiting a little while for detailed results to be reported

Aftercare

Rest for a few minutes after balance testing if you feel dizzy before heading off.
Avoid driving until any dizziness has fully settled, and arrange a lift if advised.
Restart any medicines you were asked to pause, following the team's instructions.
Make a note of any questions for when your results are explained.
Attend the follow-up appointment where detailed results and next steps are discussed.
Contact the team if dizziness is severe or lasts much longer than expected.
Report any sudden change in hearing or balance promptly, as this may need urgent review.

Before your test

Know whether you are having a hearing test, balance tests, or both
Follow any advice to avoid alcohol or certain medicines beforehand
Skip eye make-up on the day of balance testing
Bring your glasses, medicine list and symptom notes
Arrange a lift if balance tests might leave you dizzy
Note the follow-up appointment for detailed results

⚠ Get urgent help if…

Sudden hearing loss, especially in one ear — this should be assessed urgently, separately from a routine test
Dizziness with double vision, slurred speech, weakness or numbness — seek emergency help
A severe headache that is new and unusual
Severe, persistent vomiting or dizziness that does not settle after balance testing
Fainting or loss of consciousness
New ringing in one ear with hearing loss, which should be reviewed promptly

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good result is a clear picture of your hearing and balance that helps explain your symptoms and points to the right next step. Your audiogram shows the type and degree of any hearing loss, and balance tests can suggest which part of the system is involved.

Results have limits. A normal test is reassuring but does not always rule out every cause of dizziness or hearing trouble, and a result usually guides management rather than confirming a diagnosis on its own. Balance can also be affected by things these tests do not directly measure. Sometimes results are inconclusive and need repeating or combining with other tests, such as a scan. Your specialist will explain what your results mean for you.

How long it lasts

Hearing and balance can change over time, so results reflect how things are now. If your symptoms change or get worse, the tests may need repeating, and a normal result today does not guarantee things will stay the same in future.

Related tests, treatments or support

Hearing and balance tests are often done together when symptoms involve both, and individual tests such as pure tone audiometry, tympanometry, acoustic reflex testing and speech testing are usually part of the same battery. They may also be combined with an ear examination, blood tests or scans (such as an MRI) when the specialist needs more information about the cause.

Follow-up & long-term care

Some results are explained on the day, but detailed balance findings are usually reported and discussed at a follow-up appointment with an audiovestibular specialist. From there, the next step is agreed, such as hearing aids, balance physiotherapy, treatment of an underlying condition, further tests or referral.

Repeat, follow-on and what comes next

Tests sometimes need repeating if the results are unclear or affected by earwax, a cold or anxiety on the day.
More than one type of test may be needed to build a full picture.
Results can be inconclusive, and a normal result does not always rule out every cause.
Hearing and balance can change, so testing may be repeated in future if symptoms change.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

A clear, plain-English explanation of the results and what they mean.
A written report and a defined next step, such as hearing aids, physiotherapy or further tests.
A named contact if dizziness lasts longer than expected after balance testing.
A clear plan for repeat testing or referral if results are inconclusive.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

Which tests are needed and how many
Whether full balance testing is included, as it is more involved
The audiologist's or specialist's time and any specialist equipment
Whether results are reported the same day
Any follow-up appointment to discuss results
Further tests, such as scans, if the cause needs more investigation

Make sure your written quote includes

Which specific tests are included
The audiologist's, specialist's and facility fees
Whether a written report and results discussion are included
Any follow-up appointment cost
What happens, and what it costs, if more tests are needed
Whether onward referral or further investigation is included if results are abnormal

On the NHS? Hearing and balance testing is available on the NHS through audiology and audiovestibular medicine services when clinically indicated; private testing may be used for speed, convenience or choice of provider.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Choosing a specialist safely

Check the specialist is on the GMC Specialist Register for this area.
Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Questions to ask your medical professional

Take this to your consultation. A good specialist will welcome every one of these.

Am I having a hearing test, balance tests, or both, and how long will it take?
Should I avoid any medicines, alcohol or make-up beforehand?
What will this test change about my care?
What happens if the result is normal, abnormal or unclear?
Could I feel dizzy afterwards, and should I avoid driving?
Will I need any other tests, such as a scan, to find the cause?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the specialist who carries out my test, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this test not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Do the tests hurt?

No. Hearing tests are comfortable. Balance tests are usually not painful too, but the part using warm and cool air or water in the ear can make you feel dizzy or sick for a short time.

How long does it take?

A hearing test usually takes about 30 to 60 minutes. Full balance testing takes longer — up to about two hours — because it involves several separate tests.

Will I be able to drive afterwards?

After a hearing test, yes. After balance testing you may feel dizzy for a while, so it is sensible to wait until that settles and to arrange a lift if you are advised to.

Does a normal result mean nothing is wrong?

Not necessarily. A normal result is reassuring but does not always rule out every cause of hearing or balance problems. A result guides what to do next and is read alongside your symptoms, rather than being a diagnosis on its own.

Should I stop my medicines before the test?

For balance testing you may be asked to avoid alcohol and pause certain medicines for a day or two, as they can affect the results. Always follow the specific advice you are given and check before stopping anything.

What is the difference between audiology, ENT and audiovestibular medicine?

Audiologists carry out hearing and balance tests. ENT surgeons treat ear, nose and throat conditions, sometimes with surgery. Audiovestibular medicine is a medical specialty focused on hearing and balance disorders; these teams work together depending on what you need.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NHS — Hearing tests NHS — Dizziness British Society of Audiology — Recommended procedures British Academy of Audiology ENT UK — patient information RNID — What happens in an audiology appointment

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.