It's important that you get a full panel audiogram if you think your hearing might be getting worse, but how do you read the results once you get them? This article will explain what you need to know about your hearing test, so you can ask your audiologist more effective questions.
Your audiogram will be handled by a professional, likely an ENT or audiologist. Once it’s done, you’ll have a better understanding of how well you can hear, whether or not you have hearing loss, and what kind of hearing loss is present. If you do have hearing loss, an audiogram can help determine what kinds of hearing aids you can use, and how you should move forward with treatment. This is an important test, but the results can be a bit confusing to the untrained eye. So, here’s some training on how to read your audiogram.
Audiograms are completely painless, relatively quick tests that determine your level of hearing. They work by recording your responses to certain sounds and pitches, and judging your hearing based on these results. During an audiogram, you will be sat down and given a pair of stereo headphones. These go over your ears, and a series of short sounds will be played at various volumes and pitches. These sounds will be played in your left ear, right ear, and both ears. Your audiologist will also test your ability to hear certain words and phrases along with these static tones.
Then, your results are recorded on a graph. This graph is the audiogram. Both your left and right ear will be recorded separately, and their results can vary wildly or match up with one another. This graph will show how well you hear at certain volumes and frequencies, along with your word recognition score.
On your audiogram, you will see two axes. One axis (horizontal) represents frequency/pitch, while the other (vertical) represents decibel volume, or loudness, with louder sounds lower down and quieter sounds higher up. When you look at your audiogram curve, anything below it is audible to you while everything above it is not audible. If you have no hearing loss at all, the audiogram curve runs exactly along the horizontal axis.
Hearing tests usually examine people’s hearing from 250 Hertz to 8,000 Hertz, which covers all human speech and more. Vowel sounds fall within the lower range of hearing, while consonants fall within the high range. This is why most people with hearing loss struggle to hear consonants and children’s or women’s voices: they are higher frequency sounds, and you usually lose your high-frequency hearing first.
The lines on your audiogram record each ear’s hearing ability. You will find two on your audiogram, one for the right ear and one for the left. If these lines are parallel and match up, this means you have symmetrical hearing. Your ears have similar hearing abilities and there’s little to no discrepancy between them. However, many people have asymmetrical hearing, which means their ears have different hearing abilities entirely.
The line will likely fluctuate on the graph. This just means you have different levels of hearing depending on the frequency or pitch of what you’re hearing. Most people hear low-frequency sounds better than high-frequency ones, and this intensifies as you age. However, low-frequency hearing loss does exist, and your audiogram will help determine what frequencies you hear best.
Your audiogram will also determine how well you understand speech. This is represented as a Word Recognition Score (WRS). This is also called Speech Audiometry. You can find this score at the bottom of your results, as it is not recorded on the audiogram itself. This is because speech recognition and hearing ability are not the same thing, and people can have good hearing but struggle to understand words. Likewise, people with bad hearing can supplement their understanding of speech by lipreading.
If you or your child is struggling with speech, this aspect of the test can help you determine if the issue is hearing-related. If you only have trouble understanding and repeating speech, this is a sign of an auditory processing disorder or neurological condition, not hearing loss. It is important to differentiate between these two conditions before you seek treatment.
Depending on your level of hearing loss, you might have more or less trouble understanding people’s voices. If your speech recognition is low and you have hearing loss, your audiologist might recommend hearing aids. Many audiologists have a hearing aid threshold, which means they will bring up hearing aids if your hearing and speech recognition abilities fall below a certain level.
Your hearing loss will likely range from mild, moderate, severe, to profound. Your graph will show what decibel volumes you can hear at, and what your decibel threshold is. This is the quietest sound you can hear naturally.
• Mild hearing loss means the quietest sounds you can hear are at 25-40 decibels. You might struggle to hear a ticking clock.
• Moderate hearing loss means the quietest sounds you can hear are at 40-75 decibels. You might struggle to understand speech and hear telephones ringing.
• Severe hearing loss means the quietest sounds you can hear are at 75-90 decibels. You cannot hear speech without a hearing aid.
• Profound hearing loss means the quietest sounds you can hear are at 90-120 decibels, if you can hear at all. Hearing aids can be ineffective at this level.
As mentioned above, your graph might skew one way or another. This will determine whether you have high-frequency or low-frequency hearing loss. If you received higher results on low-pitched sounds versus high ones, your hearing loss is high-frequency. In the opposite direction, people who hear high-pitched sounds versus low ones have low-frequency hearing loss.
Beyond that, there are also different types of hearing loss in a more physical sense. There are three primary types of hearing loss, and they’re categorized by what is causing your loss of hearing. They include:
• Sensorineural hearing loss. This accounts for 90% of all hearing loss cases, making it the most common form of this condition. It is caused by a deterioration of the cochlea in the ear and the small hairs inside of it. When these hairs wear down, they stop picking up sound as easily. This usually affects high frequency sounds first. It is permanent, and usually requires hearing aids. Sensorineural hearing loss also includes problems with the auditory nerve, which funnels sound information to the brain.
• Conductive hearing loss. A rarer form of hearing loss that is caused by blockages or growths within the ear. These blockages can be temporary or operable, including tumors, bone growths, and earwax impactions.
• Mixed hearing loss. This is a type of hearing loss that involves both sensorineural and conductive hearing loss. While the conductive aspect can often be solved or operated upon, the sensorineural aspect is usually permanent.
If you’re concerned about understanding your results, make sure to ask your audiologist questions. Ask them to point out things on the graph and explain your hearing ability. While you can learn a lot about audiograms online, you might not have the same training or understanding they do. Most audiologists will be happy to help, and they should give you a printed copy of your results for future reference. Your audiogram results will also help hearing care professionals fit you with the proper hearing aid.
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