If you have trouble hearing, the best thing you can do is to see an audiologist for a comprehensive hearing evaluation. Once you receive the test results in the form of an audiogram, the graphs, crosses, circles, and lines might seem a little confusing at first. If you are not sure how to read them, don’t fret. In this guide, we will go through how to read and interpret a hearing test result.
You might be wondering how hearing is measured. How is it possible to tell if a person can hear well or not?
Normal hearing measures between 10 and 15 decibels for each threshold. Slight hearing loss might show between 16 and 25. Here, your doctor may suggest a follow-up audiometry test at a later stage to monitor your hearing and make sure that it does not get worse. From the other tests, we list:
Speech recognition
Speech discrimination
Tympanometry
Acoustic reflexes
Hearing threshold
Word recognition percentage
What is an audiogram?
An audiogram is a chart or graph that displays the results of your hearing test by measuring your hearing ability across a range of frequencies in each ear independently. It shows the softest sounds you can hear at each frequency (high-pitched sounds versus low-pitched sounds) and intensity (or loudness), that is how well you hear from the auditory pathway or the different parts of the ear.
What does a hearing test result look like?
Frequency or pitch is usually measured in Hertz (Hz). It is read from left to right on the audiogram. Each vertical line (right axis) represents a different frequency including 250, 500, 1000, 2000, 3000, 4000, 6000, and 8000 Hz. Normal hearing fluctuates from 20 Hz up to 20,000 Hz. The most sensitive hearing range for the average person is between 2000 and 5000 Hz.
The intensity is measured in decibels (dB). It indicates how soft or loud a sound is. Each horizontal line (left axis) characterizes a different intensity level. The softest sounds are at the top of the chart, while the loudest sounds are at the bottom. The loudest intensity tested is typically 120 dB and the softest is 0 dB.
At first, it might look like a bunch of indecipherable lines and symbols. However, once you learn how to interpret it, you can better understand your hearing loss and your audiologist will better understand your type of hearing loss as well.
We have to mention that the audiogram is quantitative and not qualitative. It uses a numerical system that measures residual hearing ability in a quiet room. It neither describes the quality of your hearing ability nor detects if you have hidden hearing loss.
Hearing Loss Levels
To start with, there are several levels of hearing loss. The normal limits where hearing is normal for an average human adult is -10 to 20 dB. Hearing loss ranges from none to profound, depending on the hearing threshold, which is the softest sound heard at a certain frequency.
1. Mild
It refers to the threshold that ranges between 20-40 decibels. At this level, you can talk with people face to face. You can understand them perfectly. What you cannot understand is the sound from far away or conversations taking place in louder spaces.
2. Moderate
It refers to the threshold that ranges between 40-70 decibels. You struggle to hear conversations no matter where the setting is. You might have difficulty hearing conversations found in noisy spaces. Some words in a conversation can be missed.
3. Severe
It refers to the threshold that ranges between 70- 95 decibels. You get confused in conversations in groups or background noise. You struggle to hear some household sounds such as the doorbell or telephone ringing. You rely on lip reading in conversation, whether consciously or not.
4. Profound
It refers to the threshold that ranges above 95 decibels, that is very little or no hearing. You rely on lip reading or using sign language, even with the use of hearing aids.
It is extremely important to note that a person with a normal audiogram can still have hearing difficulties in certain situations. For example, a person with normal hearing might find it difficult to understand the conversation with a certain background noise or coming from another room. This is what we call “hidden hearing loss.” It is a type of hearing loss when the person has a normal audiogram but has a lot of difficulty with background noise.
How to read an audiogram
Different symbols are used which indicate the thresholds on an audiogram. Each symbol on the chart represents the threshold for a given frequency. Once all of the thresholds are measured and plotted on the graph, they can be connected to form easy-to-read lines for both the right and left ears.
If both lines are overlapping, your hearing loss is considered symmetrical- that is the same in both ears.
If the lines are not overlapping, your hearing loss is considered asymmetrical- that is your ears have different degrees of hearing loss.
If you glance at your audiogram, you can determine whether you have hearing loss or not. You will see lines with red circles/triangles and blue crosses/squares. The line joined together by crosses (usually on the right) represents the hearing in the left ear, and the line joined together by circles (usually on the left) shows the hearing in the right ear. It is a little confusing, but it is made this way so your audiologist facing you can read them and interpret the results.
In short, the lower the line drops on the chart, the worse your hearing is at that specific frequency.
Results for the part of the hearing test, when you are listening through speakers, are marked with “S” " This line represents the response of at least one ear or the better hearing ear.
The right ear is graphed with < or [, and the left ear is graphed with > or]. These responses determine whether a hearing loss is conductive or sensorineural.
A steady line connecting your threshold levels at the top of the chart indicates a standard hearing.
Adults can consider themselves to have normal hearing ability if their responses indicate they heard noises between 0 and 25 dB across the frequency range.
Children are considered to have hearing ability within normal limits if their responses are between 0 to 15 dB across the frequency range.
A line rising or dropping along the chart indicates hearing loss for certain frequencies. Your audiologist will classify the severity of your hearing loss by where the symbols fall on the graph. The space between your threshold and the normal hearing area represents all the sounds you are missing because of your hearing loss. The bigger the space, the more sounds you will not be able to hear.
A line lower on the chart states extreme hearing loss.
What do the results indicate?
The most important thing is to notice at what volume the curve starts and how steeply it drops off. You can work out the overall degree of your hearing loss from mild to profound by calculating the average of the readings. Many people are surprised by the shape of their hearing test curve. This is due to the gradual presence of hearing loss and the brain’s ability to adapt to the loss, which makes it not noticeable for some time.
What to do with your test results
The audiogram that you did will provide you with all the treatment options for hearing loss. It will give guidance on how to treat the condition by articulating the type of hearing loss you have and how much hearing loss you have.
Complementing your treatment with noise protection is always essential. Some treatments include:
Hearing aids
Cochlear implants
Cleaning excessive earwax
Medication for infections or wax removal
Surgery
Ear tubes
In certain conditions, the doctor recommends additional hearing tests or diagnostic procedures to better understand your current condition, such as getting a tympanogram or middle ear exploration.
You can examine your audiogram to check if you have hearing loss. The results of your hearing test serve as a baseline for you and your audiologist to monitor any changes in your hearing down the road. Treatment will be recommended based on the type of hearing loss depicted on the audiogram and how severe it is. Be an effective participant in your hearing health care! Get your hearing test now.