A Patient Guide to Understanding Your Audiogram Results
You’ve just received a hearing test and have been diagnosed with hearing loss, but what do the results really mean? A great Audiologist will always explain to you how to read your audiogram chart after they conducted your hearing assessment. However, it is a lot of new information to take in all at once. If you’re not 100% sure about the details, fear not. We’ve created a short guide to help you understand your audiogram results.
So much is happening during a full diagnostic hearing assessment, that it can be a challenge for many to keep up – especially if it’s their first time getting a hearing test. When you then find out there is a hearing loss, it can be very overwhelming. It can all just seem like a game of noughts and crosses on the screen in front of you. The following information will hopefully explain how to put the puzzle together.
How is Hearing Tested?
Conducted by an Audiologist
A full hearing test is conducted by a health professional called an Audiologist. Audiologists have at least five years of university study and have the knowledge to deal with a range of hearing issues competently.
During Your Hearing Assessment
During a hearing test the Audiologist will seat you in a sound-proof booth with headphones over your ears or earbuds in your ears. You will hear beeps that vary in volume and pitch and your Audiologist will tell you to push a button each time you hear a beep, no matter how soft it seems to be. There are different types of hearing tests available. If you’d like to learn more, click here to read our post on Hearing Tests and Assessments.
This takes some concentration to do properly and this is one reason why it’s always better to test hearing in a sound-treated booth to get the correct results. The softest sounds heard at each pitch are your hearing thresholds and these are recorded by your Audiologist on a graph which is called an audiogram. What is an audiogram you ask?
Explaining the Audiogram
The audiogram is a graph of your hearing. This shows the volume and the pitch of the sounds. The volume or loudness is seen on the vertical axis which means that soft sounds are shown at the top of the page and as you go down the page the volume gets louder. The volume is the intensity or decibel range.
The loudest beeps can be uncomfortable if you have good hearing though your Audiologist will make sure your test is not going to get to that level. The pitch or frequency displays on the horizontal axis which means the deeper lower pitch sounds are on the left of the page and as you go across to the right of the page the pitch is higher. Like a musical scale, the bass is on the left and treble in on the right. The pitch is the frequency range or Hertz.
The audiogram below shows how day to day sounds relate, with softer sounds like leaves rustling at the top and loud sounds such as gunfire at the bottom. You will also see the different pitches with the bass sounds such as a barking dog on the left and the treble sounds like chirping birds on the right.
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But what about the big boomerang in the middle?
We’ll get to that soon but first let’s understand your hearing thresholds we mentioned earlier. Remember, hearing thresholds are the softest sounds heard at each pitch, these are the noughts and crosses the Audiologist recorded on your hearing graph. Or think of it as the softest sound at each pitch when you pushed the button during the test of your hearing.
Understanding Your Audiogram Results
Step One – Which ear has hearing loss?
Just look at the noughts and crosses.
- The noughts are the thresholds for the right ear and might be shown in RED.
- The crosses are the thresholds for the left ear and are usually shown in BLUE.
The graph below shows some hearing levels for the left ear and right ear.
Since the left ear crosses are higher on the page the hearing for this ear is closer to normal hearing, but the right ear noughts are lower on the page so show more of a hearing loss. Any of the sounds above the noughts and crosses are the sounds you could not hear during the hearing test, and any of the sounds below the noughts and crosses are the sounds you could hear.
Step Two – How much hearing loss do you have?
Any thresholds at the top of the page show normal hearing as all the sounds can be detected at soft levels. Thresholds at the bottom of the page show a profound hearing loss as all sounds are detected at the loudest levels. In between normal and profound, there are mild, moderate and severe degrees of hearing loss.
In the above audiogram the left ear (crosses) show a mild hearing loss and the right ear (noughts) show a moderate to severe hearing loss. Your audiologist will advise you about the hearing thresholds for each ear at the end of the hearing test.
Step Three – Which sounds are affected?
Each ear can have different amounts of hearing loss at each pitch, the low pitch (bass) hearing might be different to the high pitch (treble) hearing. This is where the boomerang mentioned earlier becomes important.
The shaded area of the boomerang
What you see is the speech range or the area where the sounds of speech are displayed as they happen in everyday conversation when in quiet situations. This helps in understanding how you can have a hearing loss but still hear some sounds but not hear other sounds.
The low pitch/bass sounds of speech are vowels
They also include a few other sounds like m and n. These are shown on the left end of the boomerang which mainly starts at 40dB volume.
The high pitch/treble sounds of speech are consonants
This includes p, k, ch but also the very high pitches like f and th. All these sounds give clarity to the speech we listen to. These treble sounds are shown on the right end of the boomerang which you will notice extends up higher on the volume scale starting from 20dB.
Low pitch sounds can be heard a little louder than high pitch sounds
Which means even with a mild hearing loss for low pitches some of the bass sounds can be heard. However, the high pitch sounds are very soft, softer than the low pitches and so even a mild hearing loss for high pitches can make the treble sounds unheard.
If you look again at our example, the left ear (crosses) shows normal hearing for the low pitches (bass sounds) and a mild hearing loss only for the high pitches (treble sounds). This means the left ear will have less ability to hear the soft high pitches like f and th, which will make speech less clear.
The right ear (noughts) shows a moderate hearing loss for the low pitches (bass) and a severe hearing loss for the high pitches (treble). The right ear alone has thresholds below the entire speech boomerang so can’t hear average speech at all.
Step Four – Which part of the ear is affected?
Ok this is where the audiogram gets a bit complicated!
You will also see a range of arrows and brackets on the graph of your hearing. What do they mean? Well put simply, it tells you and your audiologist what hearing you have in your inner ear or hearing nerve and connections.
During the hearing test your audiologist will place a headband on your head (nothing in your ears this time) and you will be asked to push the button for the beeps again. The softest sounds are again recorded by your audiologist at each pitch. These thresholds help your audiologist to understand where along the ear and hearing pathway there is a problem.
Look at the graph below. If the arrows and brackets are close to the noughts and crosses, the problem is most likely at the inner ear. This is typically a permanent hearing loss and hearing aids might help. Common causes of this type of hearing loss include noise exposure and ageing, which both can damage the inner ear.
Now looking at the next graph below, if the arrows and crosses are higher up the page compared with the noughts and crosses, the problem is most likely not as deep as the inner ear. It might be an issue with a blockage due to wax in the ear canal or even a blockage behind the eardrum such as fluid in the middle ear.
Often these types of problems can be fixed by seeing your General Practitioner so it is very important following a hearing test to visit your doctor if recommended. Click here to read our guide on what you need to know about looking after your hearing health post diagnosis.
Summing it up
Having a full hearing test is an important step to finding out if you have hearing loss and to what degree. The results can seem overwhelming at first but with good explanations by your Audiologist you will understand whether you need to seek further medical attention.
If your diagnosis indicates that you may need hearing aids your Audiologist will be a helpful point of contact and can discuss this with you further.
Make sure to ask your Audiologist all the questions you may have during your appointment. This ensures you have the information you need to make well-informed decisions. Your Audiologist is a hearing expert and will be happy to guide you along the way to better hearing health.
Attune Hearing is here to help you make the best decisions about your hearing health and wellbeing. If you have any further questions and would like to discuss options for further assessment and treatment with one of our skilled and friendly Audiologists, don’t hesitate to contact us today.