Audiogram Interpretation

At Audi Hearing, it’s important to understand your audiogram to effectively manage and improve your hearing health.  An audiogram is a graph that illustrates the specific details of your hearing ability, providing both you and your audiologist with essential insights into your auditory health.

Key Takeaways:

• Threshold Levels: Marks the softest sounds you can hear, helping identify the degree and type of hearing loss.
• Frequency Range: Illustrates your hearing ability across different pitches, from low to high.
• Pattern Recognition: Patterns in your hearing loss can indicate specific types of hearing health issues.

What is an Audiogram?

An audiogram is a graph that displays the results of a hearing test. It measures hearing sensitivity at different frequencies (pitches) and loudness levels. The X-axis of the graph represents frequency, measured in hertz (Hz), which ranges from low-pitched sounds (125 Hz) to high-pitched sounds (8,000 Hz or higher). The Y-axis represents the intensity or loudness of sounds, measured in decibels (dB), from very soft (40 dB) to very loud (120 dB).

During a hearing test, various tones are played through headphones or ear inserts, and the patient is asked to indicate when they can hear the sound. The audiologist notes the quietest sound the patient can detect across various frequencies. These results are plotted on the audiogram, allowing audiologists to visualise the patient’s hearing sensitivity across a range of pitches.

The Components of an Audiogram

Before diving into how to interpret an audiogram, it’s essential to understand its basic components:

• Frequency (Hz): Represented on the X-axis, frequencies range from low to high. Low frequencies are associated with deep sounds (such as a bass guitar), while high frequencies are associated with sharp, higher-pitched sounds (like birds chirping). Compe
• Intensity (dB): The Y-axis shows the loudness or intensity of sounds. The softer the sound, the higher up it is on the Y-axis. The more intense or louder the sound, the lower it appears.

Symbols for Hearing Thresholds:

• Red O (circle): Used to indicate hearing thresholds for the right ear when measured with headphones.
• Blue X (cross): Used to indicate hearing thresholds for the left ear when measured with headphones.
• Right and Left Ear Results: If bone conduction is tested (using a bone oscillator behind the ear), different symbols may be used (e.g., > for right ear, < for left ear).
• Normal Hearing Range: A normal hearing threshold is typically between 0 and 20 dB HL (hearing level) across most frequencies.

How to Interpret an Audiogram

1. Determine the Type of Hearing Loss

The first step in interpreting an audiogram is identifying the type of hearing loss, which can be broadly categorised into three types: conductive, sensorineural, and mixed.

• Conductive Hearing Loss: This type of loss occurs when sound cannot efficiently travel through the outer or middle ear to the inner ear (cochlea). On an audiogram, conductive hearing loss is indicated by a gap between air conduction (represented by circles and X’s) and bone conduction (represented by < and > symbols). Bone conduction should be normal (close to 0 dB), while air conduction shows a threshold shift (a higher dB level).
• Sensorineural Hearing Loss: This type of hearing loss results from damage to the inner ear or auditory nerve, and affects both air conduction and bone conduction equally. The audiogram for sensorineural hearing loss will show similar threshold shifts for both air and bone conduction thresholds, with no gap between them. The degree of hearing loss can be gauged by the severity of the threshold shift.
• Mixed Hearing Loss: A mixed loss occurs when there is a combination of conductive and sensorineural hearing loss. This will be evident when there is a gap between the air and bone conduction thresholds, and both air and bone conduction are above the normal range.

2. Assess the Degree of Hearing Loss

The degree of hearing loss refers to how much the hearing threshold has shifted from the normal range. This is determined by how much louder sounds need to be for the person to hear them at different frequencies. Each category not only defines the range of hearing loss but also helps in determining the most suitable treatment options. By understanding the degree of hearing loss, audiologists can recommend personalised treatment plans that may include hearing aids, cochlear implants, or other assistive listening devices. Hearing loss is classified into the following categories:

• Normal Hearing (0-20 dB): No hearing loss.
• Mild Hearing Loss (21-40 dB): Difficulty hearing soft or distant speech.
• Moderate Hearing Loss (41-55 dB): Difficulty hearing normal speech at conversational levels.
• Moderately Severe Hearing Loss (56-70 dB): Difficulty hearing normal speech unless it is loud.
• Severe Hearing Loss (71-90 dB): Challenges in hearing loud speech; amplification may be necessary.
• Profound Hearing Loss (91+ dB): Cannot hear speech even at loud levels; typically requires hearing aids or other assistive devices.

3. Analyse the Configuration of Hearing Loss

The configuration describes the pattern of hearing loss at various frequencies. Specific patterns on the audiogram correspond to different types of hearing loss:

• Flat Loss: All frequencies are affected equally, with a relatively uniform loss of hearing across the audiogram.
• Sloping Loss: The most common configuration, where hearing loss is more pronounced at higher frequencies. This is commonly seen in age-related hearing loss (presbycusis) or hearing loss caused by noise exposure.
• Notch: A steep dip in hearing sensitivity at a specific frequency, often around 3,000-6,000 Hz. This is typical of hearing loss caused by noise exposure.
• Rising Loss: Hearing loss is worse at lower frequencies, with improvement at higher frequencies. This pattern is sometimes seen in individuals with specific medical conditions or damage to the ear.
• Cookie-Bite Loss: A loss that is worse in the middle frequencies, resembling a “cookie-bite” shape on the audiogram. This pattern can be seen in some genetic hearing loss

4. Consider Speech Recognition Scores (if available)

In some cases, audiologists may also test speech recognition or word recognition scores to assess how well a person understands speech, even if they can hear it. This is usually done using a list of standardised words spoken at a loudness level the person can hear. If speech recognition scores are low, it may indicate issues with understanding speech, even if hearing thresholds are relatively good. To further evaluate your hearing capabilities, you can book an online hearing test with Audi Hearing, allowing you to conveniently assess your speech recognition abilities from the comfort of your own home.

Conclusion

Interpreting an audiogram requires a comprehensive understanding of the various components that make up the graph, including the type, degree, and configuration of hearing loss. By reading the thresholds at different frequencies, healthcare professionals can diagnose hearing loss, recommend appropriate treatment options, and monitor the progression of the condition over time. For individuals, understanding how to read and interpret an audiogram can empower them to take proactive steps toward managing their hearing health, whether through hearing aids, medical treatment, or preventive measures. Ultimately, the audiogram is a vital tool in the journey toward better hearing and improved quality of life. If you’re due for a hearing assessment or have questions about your recent audiogram, don’t hesitate to reach out to Audi Hearing. Our dedicated team is ready to provide you with the best auditory care and guide you through understanding your audiogram results. Get in touch with us today to book your appointment.

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