Hearing assessment and balance testing (Audiological and vestibular assessment)
A set of usually not painful tests that measure how well you hear and how well your balance organs are working, to help find the cause of hearing loss, 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 tests that measure your hearing and balance to help find the cause of symptoms — they do not treat anything by themselves.
- A normal result is reassuring but does not always rule out every cause, and sometimes more tests or repeat testing are needed.
- Most tests take from about half an hour up to a couple of hours, and there is usually no recovery, though balance tests can make you briefly dizzy.
- Ask what each result will change, and what happens if it is normal, abnormal or unclear.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Measures the type and degree of any hearing loss
Sudden hearing loss or sudden severe vertigo needs urgent assessment, not a routine booked test.
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...
A clear, plain-English explanation of the results and what they mean.
Hearing tests are comfortable. Balance tests, especially the caloric part with warm and cool air or water, can...
Any dizziness from balance testing usually settles within minutes to a short while. You may prefer not to drive...
Some results, such as your audiogram, are often explained on the day. You can usually return to normal activities...
More detailed balance results are reported and discussed at a follow-up appointment, where the next steps are...
What is hearing assessment and balance testing?
Hearing assessment and balance testing are a group of tests that measure two things: how well you hear, and how well the balance organs in your inner ears are working. They are used to find the cause of hearing loss, ringing in the ears (tinnitus), dizziness, vertigo or unsteadiness.
The tests are carried out by audiologists, who specialise in hearing and balance. Most are usually not painful and non-invasive — for example listening for quiet tones, or having gentle puffs of air or water in the ear while your eye movements are recorded.
These tests provide information; they do not treat anything. They can show the type and degree of hearing loss, or point to where a balance problem is coming from, which then guides what to do next. A normal result is reassuring but does not always rule out every cause, and sometimes more than one test, or repeat testing, is needed.
The results help you and your clinician decide on the next step, which might be hearing aids, balance physiotherapy, treatment of an underlying condition, further tests, 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.
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 clinician 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 stop 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 for balance tests, 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 and when they happen.
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.
The audiologist 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 at a follow-up appointment.
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
Risks & complications
- 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
- 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
- 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. 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 (a false-negative picture), or pick up findings that turn out not to explain the problem. Results are interpreted alongside your symptoms and examination, not in isolation, and sometimes need repeating.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Physical harm from standard hearing tests | Very low | Pure tone audiometry, speech testing and tympanometry are non-invasive or minimally invasive tests and do not treat the ear. | Guide sourcesClinical context |
| Temporary dizziness or nausea during vestibular testing | Common and expected during caloric/VNG testing | The test deliberately stimulates the balance system; symptoms usually settle within minutes to a short while. | Guide sourcesClinical context |
| An inconclusive or misleading result | Recognised limitation rather than a complication | Results depend on cooperation, medication effects, wax, active ear disease and whether the test reproduces the patient's symptoms. | 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.
- 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.
- 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 explains 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 balance can be affected by things these tests do not directly measure. Sometimes results are inconclusive and need repeating or combining with other tests. Your clinician will explain what your results mean for you.
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 may be combined with an ear examination, blood tests or scans (such as an MRI) when the clinician 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. From there, your clinician will agree the next step, 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 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
- Which specific tests are included
- The audiologist'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 widely available on the NHS 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.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not explaining that a normal result does not always rule out a problem.
- Not warning that balance testing can cause short-lived dizziness or nausea.
- Not making clear who will explain the results and when.
- Not saying what the result will actually change about your care.
Marketing red flags
- Suggesting a single test can rule out all causes of dizziness or hearing loss.
- Selling a long battery of tests without explaining which you actually need.
- Promising a definite diagnosis from testing alone.
- Not explaining the limits of the tests or what happens if results are normal.
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.
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?
How long does it take?
Will I be able to drive afterwards?
Does a normal result mean nothing is wrong?
Should I stop my medicines before the test?
Are these tests available on the NHS?
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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 Academy of Audiology ENT UK — patient information UCLH NHS — Information on hearing and balance tests
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.
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