Learn about the process of testing and evaluating your hearing.
Whether it’s the sound of a loved one’s voice, a favorite piece of music or an important alarm, the ability to hear contributes greatly to quality of life. So, it’s important to recognize when an individual might be suffering any loss of hearing ability, and to measure the degree and severity of that loss with an audiology exam—because it’s the first step in the journey to better hearing.
A hearing test, commonly known as an audiogram, is one of the most helpful and precise resources available today for helping individuals learn about the extent of their hearing loss. While the test is easy and painless under the supervision of a trained hearing care professional, knowing what to expect can help you feel even more empowered going into your hearing aid evaluation. Here’s what you need to know about how an audiology exam measures hearing ability, what to expect during the test and how to interpret the hearing test results.
Audiometry is the science of measuring an individual’s ability to hear variations in intensity and pitch of sound. This also includes finer details of hearing such as perceiving different frequencies, recognizing different parts of speech and distinguishing the human voice from background noise. The intensity of sound is measured in audiometry in decibels (dB), while Hertz (Hz) cycles per second measure the tone or pitch of sound.
In some cases, a healthcare provider might choose to test for hearing loss with simple examinations that can be done in the doctor’s office. These informal measures can include listening to tones from an ear examination scope, whispered voices from different directions and the use of a specialized tuning fork to test the ability to hear by air conduction (sounds traveling in the air).
The provider may also place the tuning fork against the mastoid bone behind each ear to test how well the bones conduct sound. These simple steps can verify whether hearing loss is present. If so, the provider may order a formal hearing test called an audiogram. The audiology exam is a simple and painless test to take.
First, you put on headphones attached to a device called an audiometer. Sound tones are activated to one ear, then the other. You report back to the audiologist when you can hear particular tones, and those results are mapped out on a graph, sometimes referred to as an audiogram chart.
To test speech discrimination, you will hear a series of two-syllable words at gradually decreasing volume. You will be asked to repeat the words you hear, and the lowest volume at which you can hear them will be recorded. You will also be asked to repeat a series of one-syllable words played at a constant volume.
During an acoustic reflex test, a soft plug placed in the ear will track your response to various pressures and sounds. This measures movement of the eardrum and the health of the tiny muscles of the middle ear.
When your audiogram hearing test is completed, the audiologist will review the results of your hearing exam with you. You’ll be shown a graph that indicates your level of hearing sensitivity with frequencies (also called pitch) in Hertz along the top of the graph, and sound levels in decibels along the left side of the graph.
Typically, audiograms test frequencies between 250Hz and 8,000 Hz. You will likely see labeling for measurements taken at 250 Hz, 500 Hz, 1,000 Hz, 2,000 Hz, 4,000 Hz, 8,000 Hz and possibly even more ranges.
The Xs on your audiogram graph display the softest decibel level at which you are able to hear certain frequencies with each ear, a level known as your hearing threshold. While Xs are the most common symbols on an audiogram chart, you may also see others such as Os, triangles, brackets and more. Your hearing specialist will be able to explain the meaning of these less often used audiogram symbols. Usually, they are used to convey the range of certain types of hearing.
It’s possible that each ear will show a different level of hearing loss (known as asymmetrical hearing loss), or that both ears will show the same level of hearing loss (symmetrical hearing loss). Symmetrical hearing loss is the most common age-related hearing loss.
At any given frequency, the softest decibel level at which you can hear that tone will indicate whether you have lost hearing ability for that frequency. There are several types of patterns related to frequency that hearing specialists look for in audiograms. For example, noise-induced hearing loss is often associated with a loss of hearing around 4,000 Hz. The specialist may be able to tell if you have high-frequency hearing loss which makes it difficult to clearly distinguish sounds such as women’s or children’s voices or birds tweeting. Similarly, low-frequency hearing loss makes it challenging to hear things like a bass drum or a large dog barking.
The other main component in an audiogram chart is sound level. Here are some examples of mild to severe hearing loss and their implications for sound levels in everyday life.
Audiometric testing and the resulting audiogram are important both for you to fully understand the scope and nature of your hearing loss and for the precise tuning of hearings aids, should you require them. One of the major differences between hearing aids and devices known as personal sound amplification products (PSAPs) is that hearing aids use your hearing test results to precisely fit your hearing aid to your personal needs.
Hearing loss is the result of a particular part of the ear being affected. When hearing loss is detected through an audiogram, the structure of the inner ear is tested with headphones and a device called a bone conduction transducer, in order to find the source of the issue.
What comes next depends on the cause of the hearing problem and its severity. Hearing loss based in the outer or middle ear is known as conductive hearing loss and can sometimes be improved by medical intervention. Hearing impairment caused in the inner ear is known as sensorineural hearing loss and is often permanent. Some individuals have hearing loss caused by issues in both the middle ear and the inner ear. This is called mixed hearing loss .
Once the cause of hearing loss is determined, strategies for treatment may include consultation with specialist doctors called otolaryngologists or otologists, who are experts on medical interventions and surgical approaches.
In cases that aren’t a good fit for surgical intervention, hearing aids or devices may be beneficial and help counteract permanent hearing loss.
There’s no question that hearing loss can be difficult, but an audiogram hearing test provides precise information that can lead to concrete strategies for preserving and augmenting the hearing ability that remains. An audiogram can be the first step on the road back to hearing the full range of beautiful, important, life-enhancing sounds.