Pure-tone audiometry: the test where pure tones at different frequencies assess your Hearing threshold. It usually involves Air conduction and Bone conduction tests. - Air conduction: tests that deliver sound through the outer and middle ear to gauge the entire auditory pathway. - Bone conduction: bypasses the outer/middle ear by testing directly through the skull to the inner ear, helping distinguish types of hearing loss. - Frequency (Hz): how often a sound waves vibrate per second. Human hearing typically starts around 20 Hz and goes up to 20, 000 Hz, though sensitivity varies with age. - Intensity (dB): the loudness of the tone. The audiogram plots thresholds in decibels. - Test Types: a broad umbrella for the suite of assessments, including pure-tone tests, speech audiometry, and specialized measures. - Speech audiometry: evaluates understanding of spoken language, often using a Speech Recognition Threshold (SRT) and Word Recognition Score (WRS). Reading the audiogram - Hearing Threshold: the quietest sound you can barely hear at each frequency. These thresholds are plotted for each ear. - O and X: symbols used in Audiogram Symbols to denote air-conduction thresholds. O marks the right ear, X marks the left ear. - < >: marks used for Bone conduction thresholds (the less-than and greater-than symbols indicate the right/left ear bone-conduction results, depending on the chart convention). - Masked vs unmasked: sometimes a test uses masking noise in the non-test ear to isolate the ear being tested. If masked, it’s indicated on the chart. - Configuration: the shape of the hearing loss across frequencies—flat, sloping, rising, or other patterns. Common results and what they mean - Normal hearing: thresholds within the typical range across frequencies. - Mild/Moderate/Severe/Profound hearing loss: increasing degrees of difficulty, defined by threshold ranges at various frequencies. - Types of Hearing Loss: - Conductive hearing loss: problem in the outer or middle ear; air conduction may be impaired while bone conduction remains normal. - Sensorineural hearing loss: issue in the inner ear or auditory nerve; both air and bone conduction show elevated thresholds. - Mixed hearing loss: a combination of conductive and sensorineural components. - Noise-induced hearing loss: a common form of sensorineural loss that often presents with a characteristic configuration (frequencies most affected around 3–6 kHz), and can be revealed by the audiogram’s pattern. Interpreting the shapes you’ll see - Flat: similar hearing loss magnitude across frequencies; can indicate a uniform issue. - Sloping: better hearing at low frequencies, worse at high frequencies—often seen in presbycusis or noise exposure. - Rising: worse low-frequency hearing, better at higher frequencies. - Asymmetrical: different hearing levels between ears; warrants careful evaluation for underlying causes. Why this matters: actionable insights from an audiogram - Diagnosis: determine the type of hearing loss and guide treatment options. - Hearing aids and amplification: the degree and configuration inform what kind of amplification is helpful. - Monitoring: track changes over time, especially after exposure to loud environments or after medical interventions. - Communication strategies: tailor counseling, such as using speech-to-noise strategies or room acoustics improvements. Related terms you’ll hear alongside the audiogram - Hearing sensitivity: a general term describing your ability to detect faint sounds. - Threshold shift: a change in your hearing threshold over time, often used to describe changes due to noise exposure or aging. - Masked / unmasked: reflects whether masking noise was used during testing to isolate one ear. - Word Recognition Score (WRS): a measure of how well you can identify spoken words, usually at a comfortable loudness level. - Speech Recognition Threshold (SRT): the lowest level at which you can correctly identify 50% of spoken words. - Normal hearing vs different levels of loss: helps set expectations for communication strategies and intervention plans. Practical tips for patients - Bring a history: note noise exposure, medications, and family history of hearing loss to contextualize your audiogram. - Ask about the pattern: request a brief explanation of whether your loss is conductive, sensorineural, or mixed, and what that implies for treatment. - Use and care for devices: if amplification is recommended, follow fitting and care instructions to maximize benefit. - Plan for follow-up: regular re-testing can detect progression or improvement and adjust interventions accordingly. A brief glossary you can reference - Audiogram: the graph showing hearing thresholds across frequencies for each ear. - Pure-tone audiometry: the standard test to measure hearing sensitivity using pure tones. - Air conduction and bone conduction: two pathways tested to distinguish types of hearing loss. - Decibel (dB): unit of sound intensity on the audiogram. - Hertz (Hz): unit of frequency on the audiogram. - Masked / unmasked: indicates whether the non-test ear had masking noise during testing. - O (right ear) and X (left ear): symbols for air-conduction results. - < / >: bone-conduction symbols in some charts. - Speech Audiometry: assessment of understanding speech, including SRT and WRS. - Types of Hearing Loss: conductive, sensorineural, mixed. - Hearing Levels:Normal hearing, Mild, Moderate, Severe, Profound. - Types of Hearing Loss: Conductive, Sensorineural, Mixed. - Noise-induced hearing loss: a common pattern often linked to high-frequency loss.