3 Minutes to Teach You How to Read a Hearing Test Report

Is your hearing chart like a ‘secret code’? In fact, by mastering just three key points, you can quickly assess your hearing status! The experts at Waterfall Hearing will guide you through step-by-step analysis.

I. What is an Audiogram?

Just as a thermometer measures a fever, an audiogram charts your hearing ability by measuring two key dimensions: 'Sound Frequency (Hz)' and 'Loudness (dB).' The blue line represents the left ear, and the red line represents the right ear.

Ⅱ. How to Read an Audiogram?

Horizontal Axis (X-axis): Frequency (Pitch) - Unit: Hz

It represents the pitch of a sound—how high or low it is.

From left to right, the frequency increases gradually, ranging from low to high pitch (125 Hz - 8000 Hz).

Low-frequency sounds are on the left (e.g., vowel sounds), while high-frequency sounds are on the right (e.g., birds chirping, consonants like "s," "f," "th").

Vertical Axis (Y-axis): Sound Intensity (Loudness) - Unit: dB HL

It represents the volume or loudness of a sound.

From top to bottom, the decibel value increases (0 dB HL - 120 dB HL).

Sounds are quieter towards the top and louder towards the bottom.

0 dB HL does not mean the absence of sound; some individuals with normal hearing can detect sounds as soft as -10 dB HL.

Symbols:

The right ear is typically marked in red.

"O" represents the air conduction hearing threshold for the right ear (tested via headphones or ear inserts).

"<" represents the bone conduction hearing threshold for the right ear (tested via a bone oscillator).

The left ear is typically marked in blue.

"X" represents the air conduction hearing threshold for the left ear (tested via headphones or ear inserts).

">" represents the bone conduction hearing threshold for the left ear (tested via a bone oscillator).

1. Observe the Shape

Steeply Sloping (High-Frequency Sharply Sloping): A typical presentation of noise-induced hearing loss or age-related hearing loss (presbycusis).

2. Observe the Values

The higher the plotted line connecting all frequencies is on the chart (the closer it is to the top), the better the hearing.

The lower the plotted line is (the closer it is to the bottom), the worse (or poorer) the hearing.

3. Assess the Gap

Hearing loss falls into only three main types. The first type is:

1) Conductive Hearing Loss

The air conduction curve falls below the bone conduction curve, with a measurable air-bone gap between them (typically greater than 10–15 dB).

Bone conduction thresholds generally remain within or near the normal range.

Associated conditions: cerumen impaction (earwax blockage), perforated eardrum, otitis media (middle ear infection), ossicular chain discontinuity, etc

2) Sensorineural Hearing Loss

The air and bone conduction curves essentially overlap within the same range below normal.

This indicates damage to the inner ear (cochlea) or the auditory nerve.

Associated conditions: age-related hearing loss (presbycusis), noise-induced hearing loss, sudden sensorineural hearing loss (SSNHL), etc.

3) Mixed Hearing Loss

Both the air and bone conduction curves fall below the normal range, and an "air-bone gap" exists between them.

This indicates simultaneous involvement of both the outer/middle ear and the inner ear (cochlea) or auditory nerve.

Associated conditions: damage or disorders affecting both the conductive pathway (e.g., middle ear) and the sensorineural pathway (e.g., inner ear).

III. What Does Your Audiogram Suggest?

Case Demonstration:

Right ear: Normal hearing at 250-2000 Hz and 6000 Hz; moderate sensorineural hearing loss at 3000-4000 Hz. Pure-Tone Average (PTA): Air Conduction = 21.25 dB, Bone Conduction = 18.75 dB.

Left ear: Moderate to severe gradually sloping sensorineural hearing loss, also commonly referred to as high-frequency gradually sloping hearing loss.

Recommendation: Bilateral fitting of air-conduction hearing aids with strong noise reduction capabilities.

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