An audiogram is more than a graph; it’s a clinical snapshot of how your ears hear the world. By translating sound into decibels and hertz, it reveals hearing thresholds across frequency ranges, helping clinicians differentiate types and degrees of hearing loss. Here’s a practical guide to understanding audiograms, what the patterns mean, and how they connect to everyday listening. What an audiogram measures - Pure tone audiometry is the standard test used to determine Hearing threshold levels at various Frequencies (Hz). - Air conduction tests assess the entire hearing pathway from the outer ear to the inner ear, while Bone conduction tests bypass the outer and middle ear to probe inner ear function. - Decibel (dB HL) is the unit used to express thresholds in audiograms. - Speech frequencies (500–4000 Hz) are critical for understanding speech and are routinely plotted alongside pure-tone data. - The result map shows thresholds for each ear, typically with O (right ear air conduction) and X (left ear air conduction) symbols, and < > for bone conduction if used. Frequency ranges and what they tell you - Low frequency: often 250–500 Hz - Mid frequency: roughly 1000–2000 Hz - High frequency: 4000–8000 Hz - The distribution of hearing across these ranges helps identify common patterns of loss and links to speech understanding, since speech frequencies lie mainly in the 500–4000 Hz band. Hearing loss types and what they look like on an audiogram - Conductive hearing loss: trouble with outer/middle ear; bone conduction is within normal limits while air conduction shows a loss. - Sensorineural hearing loss: inner ear or auditory nerve involved; both air and bone conduction show similar thresholds—no significant air-bone gap. - Mixed hearing loss: both conductive and sensorineural components present; air conduction worse than bone conduction with an air-bone gap. - Unilateral hearing loss: hearing loss in one ear - Bilateral hearing loss: hearing loss in both ears - Degree of Hearing Loss ranges from Normal hearing to various severities: - Normal hearing - Mild hearing loss - Moderate hearing loss - Moderately severe hearing loss - Severe hearing loss - Profound hearing loss Audiogram patterns you may see - Flat audiogram: relatively uniform thresholds across frequencies - Sloping hearing loss: poorer thresholds at high frequencies - Rising (reverse slope) audiogram: better hearing at high frequencies, worse at low-mrequencies - Notched audiogram (noise-induced notch): dip around 3–6 kHz, with recovery at other frequencies - Cookie-bite audiogram: a mid-frequency dip with better low/high-frequency thresholds Speech testing and its link to audiograms - Speech Testing often linked to audiograms to gauge real-world communication: - Speech recognition threshold (SRT): the softest level at which speech is understood 50% of the time - Speech discrimination score (SDS) or Word recognition score (WRS): how well words are correctly repeated at a given loudness - These measures complement pure-tone data to assess functional hearing capability. Symbols and clinical language you’ll encounter - O: right ear air conduction threshold - X: left ear air conduction threshold - < >: bone conduction thresholds - Masked / unmasked thresholds: sometimes masking is used to isolate each ear when there’s cross-hearing - Threshold shift: a change in hearing threshold relative to a prior test - Asymmetry: significant difference between ears - Masking: a procedural safeguard to prevent the non-test ear from influencing results - Calibration: ensuring equipment accuracy - Test reliability: consistency and trustworthiness of results How to interpret a typical patient journey - Start with a pure-tone audiogram to map Hearing threshold by Frequency (Hz) and Decibel (dB HL) for each ear. - Identify whether there is a Conductive, Sensorineural, or Mixed hearing loss and whether it is Unilateral or Bilateral. - Note the Degree of Hearing Loss and the Audiogram Pattern to decide on next steps (hearing aids, medical referral, or monitoring). - Correlate with Speech Testing results (SRT, SDS/WRS) to understand functional impact on daily communication. - Consider clinical terms like Threshold shift or Masking when evaluating changes or test design. - Report clearly, including the relevant Symbols Used on Audiograms, to ensure appropriate treatment decisions.