Otoacoustic emissions (OAE) test (otoacoustic emissions testing)
A quick, usually not painful hearing test that measures the faint 'echo' produced by a healthy inner ear in response to sound, used to check how well the cochlea is working.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- An OAE test measures the faint echo a healthy inner ear (cochlea) makes in response to sound.
- It is quick, usually not painful and needs no response, so it suits babies and people who cannot do standard hearing tests.
- It checks the cochlea only — it does not measure exact hearing levels or test the hearing nerve and brain.
- Wax, middle-ear fluid or noise can affect results, so it is often combined with other tests.
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.
Quick and usually not painful, with no needles and nothing uncomfortable
It is the wrong stand-alone test if you need to know your exact hearing levels — that needs an audiogram.
You sit quietly while soft tips in your ears play clicks or tones and the device records the echo. It takes a few minutes per ear.
Clear explanation of what the result does and does not show
You sit quietly while soft tips in your ears play clicks or tones and the device records the echo. It takes a few...
Nothing changes — you can carry on as normal. There are no after-effects.
Results are often available at the appointment, sometimes as a pass/refer, sometimes interpreted with other tests.
You may be asked to return for a repeat (for example after wax removal) or for further hearing tests such as an...
What is an otoacoustic emissions (OAE) test?
An otoacoustic emissions (OAE) test checks part of the inner ear called the cochlea. A healthy cochlea does not just receive sound — its tiny outer hair cells actively produce a very faint sound of their own in response. This is called an otoacoustic emission, a kind of 'echo'.
A small soft tip is placed at the entrance of the ear, plays quiet clicking or tone sounds, and a tiny microphone listens for the echo. If a clear echo comes back, the outer hair cells of the cochlea are working well. It is quick, usually not painful and needs no response from you, which is why it is used for newborn hearing screening and for people who cannot do a standard 'press the button' hearing test.
It is important to know what an OAE test can and cannot do. It tells the clinician whether part of the cochlea is working, but it does not measure exactly how well you hear, and it does not check the hearing nerve or the brain's hearing pathways. Ear wax, fluid behind the eardrum or background noise can affect the result.
A clear result is reassuring about cochlear function but does not rule out every kind of hearing problem.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
How OAE testing compares with a standard hearing test
| Feature | OAE test | Standard hearing test (audiogram) |
|---|---|---|
| Needs a response | No | Yes — you press a button |
| Measures exact hearing level | No | Yes |
| Checks the cochlea | Yes | Indirectly |
| Checks nerve and brain pathway | No | No (needs ABR for that) |
OAE testing is often one piece of a fuller assessment rather than a stand-alone answer.
Preparing for your test
- There is usually no special preparation needed.
- Mention if you think your ears are blocked with wax, as this can affect the result.
- Tell the clinician about any recent ear infection, discharge or a cold with blocked ears.
- For babies and young children, the test is easiest when they are settled or asleep.
- Expect a quiet room, as background noise can interfere with the measurement.
- Ask whether you will get the result at the appointment or later.
What happens
The clinician looks in your ear and places a small soft tip just inside the ear canal. The tip plays quiet clicking or tone sounds while a tiny microphone listens for the echo from the cochlea.
You do not need to do anything except sit still and quiet — there is no button to press and nothing to react to. Each ear usually takes only a few minutes. For babies, it is often done while they sleep.
The equipment shows whether a clear echo (emission) was detected. The audiologist interprets this alongside your history and, often, other hearing tests, rather than relying on the OAE result alone.
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…
- It is the wrong stand-alone test if you need to know your exact hearing levels — that needs an audiogram.
- It cannot assess the hearing nerve or brain pathways, which need an ABR or other tests.
- Results are unreliable when there is significant ear wax or middle-ear fluid, which should be addressed first.
- On its own it cannot diagnose the cause of dizziness or tinnitus.
Delay or rearrange if…
- Your ears are blocked with wax — clearing it first gives a more reliable result.
- You have an active ear infection or discharge.
- You have a heavy cold with blocked ears that may settle.
- You have had sudden hearing loss — that needs urgent medical assessment, not just an OAE.
Alternatives to discuss
- Standard hearing test (pure-tone audiogram) for exact hearing levels
- Tympanometry to check the eardrum and middle ear
- Auditory brainstem response (ABR) test to check the hearing nerve and pathway
- No test if there is no clinical concern
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
- Quick and usually not painful, with no needles and nothing uncomfortable
- Needs no response, so it works for newborns, young children and people who cannot do standard tests
- Gives objective information about how the cochlea is working
- Useful for screening and for monitoring ears over time (for example during certain medicines)
- Can help separate where in the ear a hearing problem lies when used with other tests
Risks & complications
- Brief discomfort from the soft tip in the ear canal
- The test may need repeating if there is wax, fluid or background noise
- A 'refer' or unclear result can cause worry while further tests are arranged
- A clear OAE result can be falsely reassuring if there is a problem beyond the cochlea
- An 'absent' result can occur from wax or middle-ear fluid rather than a true hearing problem
- Restless babies or noise may prevent a usable recording on the day
- Discomfort if the ear canal is sore or recently infected
The OAE test is very safe and non-invasive. The real pitfalls are interpretation: a clear result does not rule out hearing-nerve or brain-pathway problems, and an absent result is not always a true hearing loss. Ask how the result fits with your other tests, and what the next step is if it is unclear.
Published figures to discuss
The OAE test is non-invasive and carries essentially no physical risk, so complication rates are not meaningful. What matters is test performance: results can be affected by wax, middle-ear fluid, poor probe seal and background noise, and screening protocols are designed to flag ears for further testing rather than to diagnose. Both false 'refer' results (an absent emission with normal hearing) and false reassurance (a clear emission despite a nerve or central problem) are possible, which is why OAEs are interpreted alongside other tests. Robust universal figures for these vary by setting and are not quoted here.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Physical harm from OAE testing | Very low | A small probe plays quiet sounds in the ear canal; it is non-invasive. | Guide sourcesClinical context |
| False fail from wax, fluid or movement | Common in babies and children | Middle-ear fluid, vernix, noise or movement can stop emissions being recorded even when inner-ear function is normal. | Guide sourcesClinical context |
| False reassurance | Recognised limitation | OAEs assess outer hair cell function and do not rule out every type of hearing or auditory nerve problem. | Otoacoustic Emissions — StatPearls (NCBI)ncbi.nlm.nih.govSource-linked context |
| Follow-up missed after a refer result | Avoidable | A refer result usually means repeat testing or ABR/audiology, not an immediate diagnosis of permanent hearing loss. | Guide sourcesClinical 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 no recovery needed. You can return to normal activities straight away, and results are often discussed at the appointment.
- No after-effects and no restrictions afterwards
- Possibly needing a repeat test if wax, fluid or noise interfered
- Results that need combining with other tests to give the full picture
- Onward referral for a fuller hearing assessment in some cases
Aftercare
- No specific aftercare is needed.
- If wax affected the test, arrange wax removal before any repeat.
- Attend any further hearing tests that are recommended.
- Ask your clinician what the result means for your hearing and what happens next.
- Report any new ear pain, discharge or sudden change in hearing.
- A note of any ear symptoms (wax, blockage, infection) to mention
- Details of recent colds or ear infections
- Any previous hearing test results to bring
- Questions about what the result means written down
- For children, a settled or sleepy time arranged where possible
⚠ Get urgent help if…
- Sudden hearing loss in one or both ears — seek same-day medical advice
- New ear pain, discharge or bleeding from the ear
- Sudden dizziness or balance problems
- Tinnitus in one ear only, or tinnitus that pulses with your heartbeat
- Facial weakness or numbness with hearing change
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 clear OAE (a good echo) suggests the outer hair cells of the cochlea are working normally. An absent or reduced OAE suggests the cochlea may not be working well — but it can also mean wax, middle-ear fluid or a poor seal, so it does not by itself diagnose a hearing loss.
Because the test checks only part of the hearing system, results are interpreted alongside your history and other tests. A normal OAE does not measure your exact hearing and does not rule out problems with the hearing nerve or brain pathways, which need different tests such as an ABR.
An OAE result reflects cochlear function at the time of testing. Hearing can change over time, especially with age, noise exposure or certain medicines, so repeat testing may be advised for monitoring. A single result is a snapshot, not a lifelong guarantee.
Related tests, treatments or support
OAE testing is often done alongside a standard hearing test (audiogram), tympanometry (which checks the eardrum and middle ear), and sometimes an auditory brainstem response (ABR) test, so the clinician can see where in the hearing pathway a problem lies.
Follow-up & long-term care
If the result is clear and expected, you may need no follow-up. If it is absent or uncertain, you may be asked to return after wax removal or for further hearing tests, with onward referral if needed.
- Have hearing rechecked if you notice change, work in noise, or take ear-affecting medicines
- Keep ears free of excess wax to allow reliable future testing
- Attend any recommended monitoring appointments
Repeat, follow-on and what comes next
- Repeat testing is common where wax, fluid or noise interfered.
- An unclear result usually leads to further hearing tests rather than a diagnosis on the day.
- Monitoring over time may require several OAE tests.
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
- Clear explanation of what the result does and does not show
- A written report and, where needed, onward hearing tests
- A plan to repeat after wax removal if the result was affected
- Advice on when to seek help (sudden hearing loss, ear pain, one-sided tinnitus)
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:
- Whether the test is a simple screen or a detailed diagnostic OAE
- Whether it is bundled with other hearing tests (audiogram, tympanometry, ABR)
- Who carries out and interprets the test
- Whether wax removal is needed first
- Whether a follow-up consultation to discuss results is included
- The fee for the test and what is included
- Whether other hearing tests are bundled or charged separately
- Who interprets the result and whether a report is provided
- Whether a follow-up consultation is included
- What happens, and what it costs, if the test must be repeated
- The cancellation policy
On the NHS? OAE testing is widely available on the NHS, including as part of newborn hearing screening and in audiology clinics; private testing is mainly used for quicker access.
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
- Presenting a clear OAE as proof of completely normal hearing.
- Treating an absent OAE as a confirmed hearing loss without considering wax or fluid.
- Not explaining that the nerve and brain pathways are not tested by OAEs.
- No plan for what happens if the result is unclear.
Marketing red flags
- Claiming an OAE test 'fully checks your hearing'
- Selling it as a complete hearing assessment on its own
- Quoting a pass as a guarantee of normal hearing
- Pushing repeat private tests without clear clinical reason
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.
- What will this result tell you, and what will it not tell you about my hearing?
- Could wax or fluid be affecting the result, and should it be repeated?
- Do I also need a standard hearing test or an ABR?
- What is the next step if the result is absent or unclear?
- How does this fit with my symptoms?
- 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
Does the OAE test hurt?
Does a clear result mean my hearing is normal?
Why might the test need repeating?
Can babies have this test?
Is it available on the NHS?
What happens if the result is 'refer' or absent?
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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: BSA — Practice Guidance: Clinical Application of OAEs (2025) NHS England — Ear checks practising standards and clinical guidance Otoacoustic Emissions — StatPearls (NCBI) NHS — Newborn hearing screening
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.
Related guides: Auditory brainstem response (ABR) test · Auditory processing disorder (APD) assessment · Tinnitus assessment and management · Hyperacusis (sound sensitivity) assessment · Acoustic reflex testing