Here’s something nobody tells you until you really need to know it: ENTs and audiologists are not the same thing. They both work with hearing, yes. But seeing the wrong one first can cost you time, money, and (in some cases) a real window for treatment. So this guide is to help you get some clarity on who does what, and more importantly, which one you actually need right now – ENT or audiologist.
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The simplest way to think about it is this:
- ENT (Ear, Nose & Throat) is a medical and surgical specialty.
- Audiology is the assessment and rehabilitation side of hearing and balance, including hearing technology and long-term hearing care.
Most people start with an audiologist for a clear, practical hearing assessment. You then move to ENT when there’s a medical reason to investigate or treat the ear (or related structures).
Table of Contents
What an ENT does
An ENT specialist (also called an otolaryngologist) is a doctor who diagnoses and treats conditions affecting the ears, nose, throat, and related areas of the head and neck. ENT teams can prescribe medication, order scans, and perform surgery.
For ear and hearing-related problems, ENT commonly deals with things like:
- Sudden hearing loss that needs urgent medical assessment
- Persistent ear infections, ear discharge, or eardrum problems
- Middle-ear disease (for example fluid behind the eardrum, perforations, cholesteatoma)
- Dizziness/vertigo when a medical cause needs investigating
- Complex or unusual hearing loss patterns (for example one-sided or rapidly worsening hearing)
- Surgical pathways, such as grommets, certain middle-ear operations, cochlear implants, and bone conduction implant assessment (where appropriate)
What an audiologist does
An audiologist is the professional who focuses on measuring hearing and helping you hear better day to day.
In practical terms, audiologists typically:
- Assess hearing with a full diagnostic hearing test (audiogram)
- Check ear health (often including otoscopy and middle-ear checks like tympanometry)
- Explain what your results mean in real life (speech understanding, listening fatigue, hearing in noise)
- Recommend and fit pairs of hearing aids when appropriate, then fine-tune and verify them
- Provide rehabilitation and ongoing support (follow-up, adjustments, communication strategies)
In the UK, many professionals who assess hearing and fit hearing aids are regulated and expected to work within defined professional standards, including recognising when a medical referral is needed.
ENT vs audiologist: a quick comparison
ENT
- Medical doctor (and often surgeon)
- Diagnoses and treats disease
- Can prescribe medication and perform surgery
- Often involved when there are red flags, complex symptoms, or surgical options
Audiologist
- Hearing assessment and rehabilitation
- Focuses on function: understanding speech, hearing in noise, hearing technology
- Fits and supports hearing aids and long-term hearing care
- Often the best starting point for gradual hearing difficulties
When you should see an ENT
You should prioritise ENT (or urgent medical assessment) when symptoms suggest something medical needs checking or treating.
Seek urgent help for sudden hearing loss
If your hearing has suddenly changed (over a few days or less), treat it as urgent. NICE guidance recommends immediate referral for sudden onset hearing loss within the past 30 days, to be seen within 24 hours.
NHS hospital guidance also stresses urgent assessment and treatment (often steroids where appropriate), because delay can worsen the chances of recovery.
Other reasons ENT is usually the right route
- One-sided hearing loss (especially if it’s new or clearly worse on one side)
- Persistent ear pain, ongoing discharge, or repeated infections
- Dizziness/vertigo with other concerning symptoms, or where a medical cause needs ruling out
- Facial weakness, neurological symptoms, or severe symptoms alongside hearing changes (urgent)
- A lump in the neck, persistent hoarseness, or swallowing issues (ENT scope broadly includes these areas) Imperial College Healthcare NHS Trust
If you’re ever in doubt and symptoms are sudden, severe, or worsening, start with urgent care (NHS 111 / GP urgent appointment / A&E as appropriate).
When you should see an audiologist
An audiologist is often the best starting point when the problem is primarily about hearing performance, especially when it has come on gradually.
Common reasons include:
- You struggle to follow conversation, particularly in restaurants or groups
- Family members say the TV is too loud
- You can hear people talking but can’t make out the words clearly
- You feel drained after social situations because listening takes effort
- You want a baseline hearing test to understand where you stand
- You’re considering pairs of hearing aids and want properly measured options, not guesswork
A good audiology appointment should leave you with clarity on:
- what type of hearing loss (if any) is present
- what it means for real-world listening
- what your options are, including whether medical referral is sensible
If you’re not sure: a simple decision guide to ENT or audiologist
Use this as a practical starting point:
Start with an audiologist if:
- hearing difficulties are gradual
- the issue is mainly speech clarity or hearing in noise
- you want to explore hearing technology and long-term support
Start with ENT (or urgent medical care) if:
- hearing changed suddenly
- there is pain, discharge, bleeding, or repeated infections
- hearing loss is noticeably one-sided
- there is significant dizziness/vertigo or neurological symptoms
And in many real cases, the right answer is both, in the right order:
- Audiology measures the hearing and identifies patterns
- ENT investigates medical causes where needed
- Audiology delivers the long-term rehabilitation plan
What happens at each appointment
What to expect at an audiology appointment
Typically:
- Case history (what you notice, when it started, where it bothers you most)
- Ear check (to look for wax, infection signs, eardrum issues)
- Hearing assessment (tone testing and often speech measures)
- Discussion of results in plain English
- Recommendations:
- monitoring
- earwax management
- onward medical referral where appropriate
- a hearing plan, which may include pairs of hearing aids and follow-up care
What to expect at an ENT appointment
Typically:
- Medical history and examination of ears/nose/throat
- Possible further tests (more specialised hearing tests, balance tests)
- Consideration of imaging or other investigations where appropriate
- Medication or procedural/surgical options when relevant
Common myths
“ENT is who you see for hearing aids”
ENT may diagnose and treat medical causes, but hearing aid selection, fitting, and optimisation is usually led by audiology.
“Audiologists can’t spot anything medical”
A competent audiologist should be alert to red flags and refer onward when needed. In the UK, regulated hearing professionals are expected to work within standards and identify when medical opinion is required.
“If I have hearing loss, it must be wax”
Wax is common, but it’s not the default explanation. A proper assessment checks for wax and measures the actual hearing so you’re not guessing.
Frequently Asked Questions
Do I need a GP referral to see an ENT?
On the NHS, usually yes. Privately, you can often self-refer, depending on the service. If symptoms are sudden or severe, seek urgent medical advice rather than waiting.
Can I go straight to an audiologist?
If going through the NHS you may need a referral from your GP. Privately you do not. For gradual hearing difficulties it’s often the fastest way to get a clear answer. If anything suggests a medical issue, the audiologist should guide you on next steps.
What if my hearing is suddenly worse in one ear?
Treat it as urgent. NICE guidance recommends immediate referral for sudden onset hearing loss within the past 30 days, to be seen within 24 hours.
Will ENT do a hearing test?
Often ENT services work alongside audiology teams. You may have hearing tests as part of the pathway, but ENT’s role is medical diagnosis and treatment.
ENT vs audiologist: what’s the difference?
ENT is a medical and surgical specialty. Audiologists assess hearing and provide rehabilitation, including hearing technology and long-term hearing care.
Who should I see first for gradual hearing loss?
An audiologist is usually the best starting point. They can test your hearing, explain the results, and recommend a plan.
Do I need ENT before getting hearing aids?
Not always. Many people can start with an audiologist. ENT is important when symptoms suggest a medical cause needs investigation or treatment.