Understanding Your Hearing Test Results: What the Audiogram Means

You've just had a hearing test, and your audiologist hands you a chart filled with symbols, lines, and numbers. If you're feeling confused, you're not alone. The audiogram, a graph that shows your hearing test results, can look intimidating at first glance, but it's actually a tool that provides valuable insights into your hearing health.

In this guide, we'll walk you through everything you need to know about reading and understanding your results. You'll learn what the graph means, why certain frequencies matter more than others, and what your results indicate about your hearing.

What Is an Audiogram?

An audiogram is a visual representation of the softest sound you can hear across different frequencies (pitches). It's created during a test called pure tone audiometry, where you listen to various tones through differing transducers and indicate when you can hear them.

The Two Key Measurements

Frequency (Pitch) 

- Measured in Hertz (Hz) or Kilohertz (kHz)

- Displayed horizontally across the top and/or bottom of the chart
- From left to right, the graph ranges from 125 Hz (low pitch) to 8000 Hz (high pitch)
- Low frequencies: bass sounds, thunder, foghorn
- High frequencies: birds chirping, consonants like "s" and "f" 

Intensity (Loudness) 

- Measured in Decibels Hearing Level (dB HL) 
- Displayed vertically along the side
- Ranges from -10 dB (very quiet) to 120 dB (very loud)
- The lower down the chart, the louder the sound needs to be for you to just be able to hear it.

Reading the Graph: The Basics

Understanding the Symbols

O (circles) = Right ear  

X (crosses) = Left ear  

< or > = Bone conduction results (sound transmitted through the bone) 

[ or ] = Masked results (used when one ear is much better than the other)

The "Banana" of Speech

One of the features you might see on your audiogram is the "speech banana"; a grey coloured region in the shape of a banana that contains most of the sounds in human speech. This typically falls between 250-6000 Hz at 20-60 dB. 

Types and Degrees of Hearing Loss

Audiologists classify hearing loss by the the type of hearing loss and degree of severity based on where your thresholds fall:

Type

Your audiogram may show two sets of results:
Air Conduction (X's and O's) - Sound travels through your ear canal, eardrum, and middle ear bones. This is how we normally hear.
Bone Conduction (< and >) - Sound travels through your skull bones directly to your inner ear, bypassing the outer and middle ear.

- If air and bone conduction results are similar: it is likely a sensorineural hearing loss (inner ear or nerve issue)
- If air conduction is worse than bone conduction: it is likely a conductive hearing loss (outer or middle ear problem)

- If both types of hearing loss are present it is considered a mixed hearing loss
This distinction helps determine the treatment options and management strategy.

Degree

Normal Hearing: You can hear most sounds without difficulty.

Mild Hearing Loss: Soft sounds may be difficult to hear. You might struggle in noisy environments or miss some parts of conversation. 
Moderate Hearing Loss: Normal conversation becomes challenging. You often ask people to repeat themselves. 
Moderately - Severe Hearing Loss: Speech is difficult to understand without hearing aids. 
Severe Hearing Loss: You can only hear very loud sounds. Communication without hearing aids is extremely difficult.
Profound Hearing Loss: Most sounds are inaudible without amplification. Cochlear implants may be recommended.

In the audiogram above we see a mild to moderately-severe sensorineural hearing loss in the right ear and a mild to profound mixed hearing loss in the left ear. 

Speech Testing Results

Your audiogram may also include speech testing results, which are more complex than pure tone audiometry. 

Speech Recognition Threshold (SRT) - Measures speech understanding in quiet situations. It is the minimum hearing level at which an individual can correctly repeat 50% of the speech material. This test is a measure of speech recognition; the level at which the patient can recognise and recall the word.

QuickSIN (Quick Speech-in-Noise Test) - Measures speech understanding when background noise is present. During this test, you'll hear sentences with increasing levels of background noise, revealing how much louder speech needs to be compared to the noise for you to understand it. 

Your Next Steps

Understanding your audiogram is the first step toward taking control of your hearing health. With this knowledge, you can have informed conversations with your audiologist, make confident decisions about treatment options, and track changes in your hearing over time. Remember, hearing loss is highly treatable, and early intervention leads to the best outcomes. The insights your audiogram provides are powerful tools for maintaining your connection to the people and sounds that matter most.

Contact ER Audiology today to schedule your comprehensive hearing evaluation. Our experienced audiologist will walk you through your results and help you explore the best solutions for your unique needs.

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