Dead Regions Detector
Unmask Hidden Hearing Gaps
Hearing loss does not always affect the inner ear evenly. In some cases, certain sound frequencies stop being processed effectively, creating “dead regions” within the cochlea. People may notice distorted sound quality, poor clarity despite amplification, or limited benefit from hearing aids. These changes often develop gradually and are not always obvious on standard hearing tests.
Advanced Hearing & Balance Tests
Advanced Hearing & Balance Tests
Identifying Cochlear Dead Regions Accurately
Pinpointing Where Hearing No Longer Responds Normally
The threshold equalising noise (TEN) Test is designed to identify areas of the inner ear where sound is no longer processed effectively, known as cochlear dead regions. During the test, tones are presented alongside a specialised masking noise. If a tone becomes much harder to hear in the presence of this noise, it suggests reduced or absent function in that frequency region.
At Harley Street Audiovestibular Clinic, TEN testing is carried out as part of a detailed hearing assessment and is non-invasive and well-tolerated. The test provides critical information for understanding sound distortion and guides safe, effective hearing management rather than relying on trial-and-error amplification.
OUR REVIEW
Trusted by Patients,
Proven by Results
EXCELLENT Based on 112 reviews Posted on Google Diana GranadosTrustindex verifies that the original source of the review is Google. I had an outstanding experience with Harley Street Vestibular Clinic and cannot recommend them highly enough. I developed severe vertigo while visiting London, and it was an incredibly frightening experience as it was my first time ever experiencing dizziness like that. I called the clinic on a Saturday, fully expecting to leave a voicemail since they were closed. To my surprise, the office manager, Preeti, returned my call that same day. I was so grateful. She was kind, reassuring, and went above and beyond to arrange an appointment for me first thing on Monday. From the moment I arrived, the entire team was professional, efficient, and compassionate. They understood how urgent and distressing my symptoms were and made every effort to see me as quickly as possible. The vestibular audiologist was exceptional—she took the time to thoroughly evaluate me, clearly explain everything she was doing, answer every one of my questions, and perform the appropriate treatment. I never felt rushed, and her expertise immediately gave me confidence that I was in the right hands. The clinic was incredibly responsive, organized, and genuinely caring throughout the entire process. They turned what was a very scary situation into one where I felt supported and well cared for. I am truly thankful to Preeti and the entire team for their kindness, professionalism, and outstanding care. If you are experiencing vertigo, dizziness, or balance problems, I would not hesitate to recommend Harley Street Vestibular Clinic.Posted on Google erika thomaziTrustindex verifies that the original source of the review is Google. Great positive experience!Posted on Google Carol BunyanTrustindex verifies that the original source of the review is Google. I could not fault my follow up appointment with Dr Aran and his team. He really does take the time to listen to your questions and really puts himself out to set you on the road to recovery . He genuinely seems interested in getting you better. I would highly recommend this practice.Posted on Google Ged RobinsonTrustindex verifies that the original source of the review is Google. Dr Benjamin Shaw was extremely thorough in his assessment of my recent attacks of vertigo. I have total confidence in his ability, once I have completed the further tests he has arranged at the Wimbledon clinic, to diagnose what is causing this issue with my health.Posted on Google Adrian LoweTrustindex verifies that the original source of the review is Google. I thoroughly recommend the Harley Street Audio Vestibular Clinic. I had an appointment with Dr Rudy Palaniappan who listened carefully to me, conducted a brilliant examination and explained everything to me with a future plan very clearly. I was really impressed!Posted on Google EvanTrustindex verifies that the original source of the review is Google. Dr Arun provided an excellent virtual consultation, took the time to understand symptoms and history and provided an initial diagnosis and treatment plan. It did not feel rushed or with any bias. Received comprehensive notes and summary promptly after the appointment. Would fully recommend.Posted on Google shahram zarafshanTrustindex verifies that the original source of the review is Google. Dr. Arun Pajaniappane is a brilliant and expert doctor. He was also incredibly friendly, making for a truly excellent experience.Posted on Google Vasile BaltacTrustindex verifies that the original source of the review is Google. I had an excellent consultation where both the doctor Arun Pajaniappane and the audiologist were highly professional, attentive, and genuinely responsive to my concerns. They listened carefully to my problems and explained everything clearly throughout the appointment. The procedures carried out were handled with great care and efficiency, which made me feel comfortable and well looked after. I very much appreciated their professionalism and patient-centred approach.Posted on Google Carol lansleyTrustindex verifies that the original source of the review is Google. My first consultation with Dr Arun Pajaniappane was an excellent experience. He listened carefully to me & did extensive tests to try to determine the correct diagnosis.
Pinpointing the Cause
Clarity Before Intervention
Dead Zone Decoders
Assessment begins with a detailed history, ear examination, and comprehensive hearing tests, including Pure Tone Audiometry and speech-based measures. We recommend TEN testing when hearing quality, amplification benefit, or clarity does not match routine results.
Management is non-surgical. Findings guide hearing aid programming, frequency-specific strategies, or monitoring. Further investigation or referral is considered only when results suggest broader involvement of the auditory pathway or when hearing difficulties persist and affect daily communication despite appropriate support.

Revive Ruin with Our Rigour
At Harley AVM, TEN testing is interpreted by clinicians with physician expertise in complex hearing loss and cochlear function. Our focus on audiovestibular medicine allows us to integrate TEN findings with speech understanding, listening effort, and real-world hearing needs. We prioritise clear explanation and shared decision-making so patients understand what the results mean for their hearing options.
Testing, hearing planning, and follow-up are coordinated through one clinic, ensuring continuity of care. If hearing aids feel ineffective, sound quality remains distorted, or clarity continues to decline, we invite you to book an assessment, request a call back, or submit an enquiry to explore personalised next steps with our team.

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Conditions We Are Treating At Harley Street Audiovestibular Clinic
Expert Medical Care for Hearing, Tinnitus & Balance
Request An Appointment With One of Our Consultants
If you are living with dizziness, vertigo or unsteadiness, our team can help identify the cause. Your consultant will carry out the right combination of tests, explain the results in clear language and agree a treatment plan with you - so you know exactly what is happening and what can be done.