ENT or Audiologist for Hearing Loss? Who Should You See First?

Brief Answer: Should You See an ENT or Audiologist?

Neither an ENT nor an audiologist is automatically “better.” The right choice depends on the problem. If your primary concern is gradual hearing loss, difficulty understanding speech, tinnitus, a hearing test, or hearing aids, an audiologist is usually the appropriate place to start. If you have ear pain, drainage, recurrent infections, a structural ear problem, or a condition that may require medication or surgery, an ENT is generally the appropriate specialist. Sudden hearing loss requires urgent medical attention.

Audiologists and ENTs work with many of the same patients, but we do very different jobs.

I have been an audiologist for 28 years, and I regularly meet patients who assume they need to see an ENT before they can have their hearing evaluated. Usually, they do not.

On the other hand, there are certain symptoms where I absolutely want a patient evaluated medically.

The easiest way to decide is not to ask, “Who is better, an ENT or an audiologist?” The better question is: “What problem am I trying to solve?”

Here is how I explain the difference to my patients.

ENT vs. Audiologist at a Glance

Your Concern	Ususally Start With
Gradual hearing loss	Audiologist
Trouble understanding conversations	Audiologist
Hearing test	Audiologist
Hearing aid evaluation	Audiologist
Hearing aid fitting or programming	Audiologist
Routine tinnitus evaluation	Audiologist
Hearing protection	Audiologist
Sudden hearing loss	Urgent medical evaluation / ENT
Ear pain	ENT
Drainage or bleeding from the ear	ENT
Recurrent ear infections	ENT
Eardrum or structural ear problem	ENT
Ear condition potentially requiring medication	ENT
Ear condition potentially requiring surgery	ENT
Significant unexplained asymmetry or other concerning findings	Audiologist may identify it and refer to ENT
Dizziness or balance problems	Depends on the symptoms and cause

This is not an absolute rule. Audiologists and ENTs frequently work together, and one professional may refer you to the other when appropriate.

What Is the Difference Between an Audiologist and an ENT?

The simplest distinction is this: An audiologist specializes in hearing and balance function. An ENT is a physician who medically and surgically treats diseases and disorders of the ear, nose, throat, head, and neck.

There is overlap, but the training and focus are different.

What Does an Audiologist Do?

An audiologist is a healthcare professional specializing in the evaluation and management of hearing, auditory function, tinnitus, and certain balance disorders.

Audiologists perform comprehensive hearing evaluations, determine the type and degree of hearing loss, evaluate how well someone understands speech, recommend appropriate hearing treatment, and fit and program prescription hearing aids when appropriate.

Diagnostic hearing testing
Speech understanding testing
Middle-ear testing
Tinnitus evaluation and management
Hearing aid selection
Hearing aid fitting and programming
Real Ear Measurement and verification
Hearing aid troubleshooting
Hearing conservation
Custom hearing protection
Counseling and auditory rehabilitation
Referral for medical evaluation when testing reveals a concern

Audiology is not simply about selling hearing aids. A large part of our job is determining what is happening with the auditory system and what should happen next.

What Does an ENT Do?

ENT stands for ear, nose, and throat doctor. The medical specialty is formally called otolaryngology-head and neck surgery.

An ENT is a physician, either an M.D. or D.O., trained to diagnose and medically or surgically treat diseases involving the ears, nose, throat, and related structures of the head and neck.

Ear infections
Eardrum perforations
Chronic middle-ear disease
Ear drainage
Structural abnormalities
Certain causes of dizziness
Sudden sensorineural hearing loss
Sinus disease
Tonsil and throat problems
Voice and swallowing disorders
Head and neck masses or tumors
Conditions requiring medication or surgery

That is a very different role from an audiologist.

Should I See an Audiologist or ENT for Hearing Loss?

For gradual hearing loss, I generally recommend starting with an audiologist.

Maybe you have noticed that:

People seem to mumble
Your spouse says you are not hearing
You turn the television louder than everyone else
Restaurants have become difficult
You can hear people talking but do not always understand the words
You are asking people to repeat themselves
Certain voices are harder to understand
Hearing in background noise has become frustrating

Those are exactly the kinds of concerns a comprehensive audiological evaluation is designed to investigate.

An audiologist can determine whether hearing loss is present, whether it affects one or both ears, what frequencies are affected, how well you understand speech, and whether the pattern of hearing loss looks like something that should receive additional medical evaluation.

If there is a reason for you to see an ENT, we refer you. That is an important part of being an audiologist.

Starting with an audiologist does not prevent you from seeing an ENT. It can help determine whether you actually need one.

If you are concerned about your hearing, learn more about our hearing evaluations and testing.

Do I Have to See an ENT Before Getting Hearing Aids?

For most adults, no.

If your primary problem is gradual hearing loss and you are considering hearing aids, you generally do not need to make an ENT appointment simply to begin the hearing-aid process.

An audiologist can evaluate your hearing, determine whether hearing aids are appropriate, discuss your listening needs, and help select and fit the appropriate technology.

If the evaluation reveals something that requires medical attention, that is when a referral becomes important.

If hearing aids are appropriate, you can then compare hearing aid styles and technology based on your hearing loss, lifestyle, preferences, and budget.

When Should I See an ENT Instead of an Audiologist?

There are situations where the problem is primarily medical rather than audiological. An ENT is generally the more appropriate starting point when you have symptoms such as:

Ear Pain

Persistent or significant ear pain can be caused by infection, inflammation, trauma, or another medical condition. That is medical territory.

Drainage or Bleeding From the Ear

Fluid, pus, blood, or persistent drainage from the ear warrants medical evaluation.

Recurrent Ear Infections

If you repeatedly develop ear infections or have persistent middle-ear fluid, an ENT can evaluate the medical cause and determine whether medication, a procedure, or another treatment is appropriate.

Known Eardrum Problems

A perforated eardrum or other structural abnormality may require medical or surgical evaluation.

Ear Trauma

An injury involving the ear or head may require medical assessment rather than a routine hearing evaluation.

A Condition That May Require Medication or Surgery

Audiologists do not perform ear surgery. When the underlying problem requires medical or surgical treatment, that is the ENT’s role.

If the primary question is “How is my hearing functioning?” think audiologist. If the primary question is “Is there a disease, injury, or structural condition that needs medical or surgical treatment?” think ENT.

Sudden Hearing Loss Is Different: Do Not Wait

If your hearing suddenly drops in one ear or both ears over a matter of hours or a few days, do not treat it like ordinary gradual hearing loss.

Sudden sensorineural hearing loss can be a medical emergency.

People sometimes wake up with one ear feeling blocked and assume it is wax, allergies, congestion, or fluid. Sometimes it is. But you cannot safely make that assumption yourself.

The National Institute on Deafness and Other Communication Disorders advises that symptoms of sudden deafness should be considered a medical emergency and evaluated immediately. Audiometry is also important because it helps determine whether the change represents sensorineural hearing loss rather than a conductive problem such as wax or middle-ear dysfunction.

If your hearing suddenly changes, seek prompt medical attention. Do not wait several weeks to see whether it comes back on its own.

Should I See an ENT or Audiologist for Tinnitus?

For many people with tinnitus, particularly persistent ringing, buzzing, hissing, or other sounds associated with hearing loss, an audiologist is a reasonable place to start.

Audiologists can evaluate hearing and assess how tinnitus is affecting you. At Delray Hearing Center, our tinnitus evaluation and management begins by looking carefully at hearing and the characteristics of the tinnitus.

But tinnitus is not one single condition. Certain presentations deserve additional medical evaluation. For example, tinnitus that begins suddenly, is strongly one-sided, occurs with a sudden hearing change, or sounds like a pulse may warrant further medical investigation.

A good audiologist is not trying to keep every patient inside the audiology office. Part of our responsibility is recognizing when something falls outside routine hearing care and referring appropriately.

Should I See an ENT or Audiologist for Dizziness?

This one is more complicated. Both audiologists and ENTs can be involved in evaluating dizziness and balance disorders.

Your balance system involves the inner ear, eyes, brain, nervous system, muscles, and other systems. “Dizziness” can also mean very different things to different people. Some people mean the room is spinning. Others mean they feel lightheaded. Others feel unstable when walking. Those are not necessarily the same problem.

Audiologists with appropriate vestibular training can perform specialized testing of the auditory and vestibular systems. ENTs evaluate medical and structural causes of vestibular problems and can provide medical or surgical treatment when appropriate.

Depending on the symptoms, other specialists such as neurologists, cardiologists, physical therapists, or primary-care physicians may also become involved. So dizziness is one area where I would not tell every patient, “Always see the audiologist first” or “Always see the ENT first.” The symptoms matter.

What If My Hearing Is Worse in One Ear?

Asymmetrical hearing deserves attention. It does not automatically mean something dangerous is happening. There are many reasons one ear may test differently from the other.

But significant unexplained asymmetry is something an audiologist should recognize and determine whether medical evaluation is appropriate.

This is a good example of how audiologists and ENTs work together. The audiologist measures auditory function. If the pattern raises concern for an underlying medical problem, the patient can be referred to an ENT or another appropriate physician for further evaluation.

What If I Just Want a Hearing Test?

Go to an audiologist. Hearing evaluation is one of our primary areas of expertise.

A comprehensive hearing test can evaluate much more than whether you can hear a beep. Depending on the reason for testing, an audiological evaluation may assess:

Hearing sensitivity
Air-conduction hearing
Bone-conduction hearing
Speech reception
Word recognition
Middle-ear function
Differences between the ears
Patterns that could indicate the need for further medical evaluation

If you have never had your hearing checked and simply want to establish where your hearing stands, an audiologist is the logical place to begin. You can see what is involved in a comprehensive hearing evaluation at Delray Hearing Center.

Do I Need a Referral to See an Audiologist?

Often, no. Many patients can schedule directly with an audiologist without first visiting a primary-care physician or ENT.

Insurance is a separate issue. Your insurance company may require a physician referral or order for certain services to be covered even when the audiologist does not require one to see you.

Can you see an audiologist directly? Often, yes. Will your insurance require a referral to pay for the visit? That depends on your individual plan.

Read more in Can You See an Audiologist Without a Referral? For questions about coverage, see Does Insurance Cover an Audiologist?.

Is an Audiologist a Doctor?

Most audiologists entering clinical practice today hold a Doctor of Audiology, or Au.D., degree. An audiologist with an Au.D. is a doctor of audiology. An audiologist is not a physician unless that individual separately holds a medical degree.

An ENT is a physician, either an M.D. or D.O. The distinction matters because the two professions have different scopes of practice.

An audiologist’s doctoral training centers on hearing, auditory function, balance, hearing technology, rehabilitation, and related areas. An ENT’s medical training prepares the physician to diagnose disease, prescribe medication, and perform surgery involving the ear, nose, throat, head, and neck.

One does not make the other unnecessary. They perform different jobs.

Is an ENT Better Qualified to Test My Hearing Because They Are a Medical Doctor?

Not necessarily. Being a physician and being a hearing specialist are different things.

Audiologists spend their professional careers evaluating hearing and auditory function. A comprehensive audiological evaluation is specifically within an audiologist’s area of expertise.

ENT physicians frequently rely on audiologists to perform detailed audiological testing because that information helps the physician determine whether a medical or surgical condition is present. Likewise, audiologists rely on ENTs when we identify something that needs medical evaluation.

The professions are complementary, not competing.

After 28 years as an audiologist, I do not view a referral to an ENT as losing a patient. If I see something that needs medical attention, sending that person to the appropriate physician is exactly what I am supposed to do.

Will an ENT Sell Me Hearing Aids?

It depends on the practice. Many ENT practices have audiologists working within the office who evaluate hearing and fit hearing aids. In that situation, the ENT handles medical and surgical care while the audiologist provides audiological care.

Other ENT practices may refer patients to an independent audiologist for hearing aids and rehabilitation. What matters is not whether the professionals are under the same roof. What matters is that you receive the appropriate evaluation and treatment from the appropriate professional.

Should I See an Audiologist Before Buying Hearing Aids?

I believe a professional hearing evaluation provides information that simply shopping for a hearing aid does not.

Before recommending a hearing aid, I want to know:

What type of hearing loss you have
How severe it is
Whether both ears are similar
How well you understand speech
Whether your middle-ear function appears normal
Whether anything in the results warrants medical referral
Where and when you are having difficulty hearing
What you are trying to accomplish with treatment

Only then does it make sense to start talking about technology.

At Delray Hearing Center, we work with multiple major hearing aid manufacturers rather than limiting patients to a single brand. Explore our hearing aid technology and treatment options.

Audiologist vs. ENT: Who Should I See First?

Start With an Audiologist If:

Your hearing has gradually declined
You have trouble understanding speech
You struggle in restaurants or background noise
Family members think you are not hearing well
You need a hearing test
You are considering hearing aids
Your existing hearing aids need evaluation or programming
You have ongoing tinnitus without an obvious medical emergency
You want advice about protecting your hearing

Start With an ENT or Seek Medical Care If:

Your hearing suddenly decreases
You have significant ear pain
Your ear is draining or bleeding
You have repeated ear infections
You have known structural ear disease
You have experienced significant ear or head trauma
Your condition may require medication
Your condition may require surgery
You have another concerning medical symptom associated with the hearing problem

And remember that sometimes the correct answer is both.

Why Starting With an Audiologist Often Makes Sense for Gradual Hearing Loss

When someone’s main complaint is gradual hearing difficulty, an audiologist can usually answer the first important question: “Is there actually a hearing loss, and if so, what kind?”

That information helps determine the next step. Maybe your hearing is normal. Maybe you have a typical pattern of age-related or noise-related sensorineural hearing loss. Maybe hearing aids are appropriate. Maybe something in the evaluation indicates that you should see an ENT.

The hearing evaluation creates a roadmap. You do not necessarily need to schedule multiple physician visits before finding out whether you have hearing loss in the first place.

Finding an Audiologist in Delray Beach

If you are searching for an audiologist in Delray Beach, look beyond who happens to appear first in an advertisement.

Ask about the professional’s credentials, experience, testing protocols, hearing aid selection, verification procedures, and whether the practice is comfortable referring patients for medical care when appropriate.

I am Adam Locker, Au.D., and I have practiced audiology for 28 years.

At Delray Hearing Center in Delray Beach, Florida, our approach starts with determining what is happening with your hearing. If the problem belongs in our office, we will explain your options. If something needs an ENT or another medical specialist, we will tell you that too.

Learn more about working with an audiologist in Delray Beach, FL or read more about Dr. Adam Locker and Delray Hearing Center.

Frequently Asked Questions About Audiologists vs. ENTs

Is it better to go to an ENT or audiologist?

Neither is universally better. For gradual hearing loss, hearing testing, hearing aids, and many tinnitus concerns, an audiologist is usually the appropriate place to start. For ear pain, drainage, recurrent infections, structural ear disease, or problems requiring medication or surgery, an ENT is generally more appropriate. Sudden hearing loss requires urgent medical attention.

Should I see an ENT or audiologist for hearing loss?

If your hearing has gradually declined, start with an audiologist for a comprehensive hearing evaluation. If the audiologist identifies a finding requiring medical evaluation, you can then be referred to an ENT. Sudden hearing loss is different and should be evaluated urgently.

Should I see an ENT or audiologist for tinnitus?

An audiologist is often a reasonable starting point for persistent tinnitus because hearing loss commonly needs to be evaluated as part of the assessment. Sudden, strongly one-sided, pulsatile, or otherwise medically concerning tinnitus may require additional physician evaluation.

Should I see an ENT or audiologist for hearing aids?

An audiologist specializes in evaluating hearing and selecting, fitting, programming, and verifying hearing aids. You generally do not need an ENT simply because you are considering hearing aids unless a medical concern is present.

Should I see an ENT or audiologist for ear pain?

Ear pain is a medical symptom, so an ENT or another appropriate medical provider is generally the better choice.

Should I see an ENT or audiologist for an ear infection?

An ENT is the appropriate specialist for recurrent, persistent, or complicated ear infections because an ENT physician can provide medical and surgical treatment.

Should I see an ENT for sudden hearing loss?

Sudden hearing loss should be treated as a medical emergency and evaluated promptly. Do not assume sudden muffled hearing is simply wax, congestion, or allergies.

Can an audiologist tell if I need an ENT?

Yes. Part of a comprehensive audiological evaluation is identifying hearing patterns and other findings that may warrant additional medical evaluation. When appropriate, an audiologist can recommend referral to an ENT or another physician.

Can an audiologist diagnose hearing loss?

Yes. Audiologists are trained to evaluate and diagnose hearing loss and other auditory disorders and to determine the type and degree of hearing impairment.

Can an audiologist prescribe medication?

Audiologists do not generally prescribe medications or perform surgery. Those treatments fall within physician practice.

Do I have to see an ENT before seeing an audiologist?

Usually not. Many people can schedule directly with an audiologist. However, your health insurance plan may have separate referral or authorization requirements for coverage.

Is an audiologist a doctor?

An audiologist who holds an Au.D. has earned a Doctor of Audiology degree. An audiologist is not a medical physician unless that individual separately holds an M.D. or D.O. degree.

Do ENTs and audiologists work together?

Yes. Audiologists frequently refer patients to ENTs when medical evaluation is warranted, and ENTs frequently rely on audiologists for hearing testing, hearing aids, and audiological rehabilitation.

Bottom Line: ENT or Audiologist?

If your main concern is how well you are hearing, an audiologist is usually the right place to start. If your main concern is a medical or structural problem involving the ear, an ENT is generally the right specialist.

For gradual hearing loss, difficulty understanding conversations, hearing testing, hearing aids, or many tinnitus concerns, start with an audiologist.

For persistent ear pain, drainage, recurrent infections, structural problems, or conditions potentially requiring medication or surgery, see an ENT.

And if your hearing suddenly drops, seek medical attention promptly.

After 28 years in audiology, one of the things I have learned is that good hearing healthcare is not about an audiologist trying to do an ENT’s job or an ENT trying to do an audiologist’s job. It is about getting the patient to the right professional at the right time.

Sometimes that is me. Sometimes it is an ENT. Sometimes we both need to be involved.

The right provider is the one whose expertise matches the problem you are actually experiencing.

If your concern is hearing loss, tinnitus, or difficulty understanding speech and you are looking for an audiologist in Delray Beach, you can begin with a comprehensive hearing evaluation at Delray Hearing Center.

About the Author

Adam Locker, Au.D., ABA Certified, is a Board Certified Doctor of Audiology and owner of Delray Hearing Center in Delray Beach, Florida. Dr. Locker has 28 years of experience in audiology and hearing healthcare, helping patients evaluate hearing loss, understand hearing technology, and determine when medical referral is appropriate.

Learn more about Dr. Adam Locker and Delray Hearing Center.

Is It Better to Go to an ENT or Audiologist? An Audiologist Explains Who You Should See First