How To Read an Audiogram: Understanding Your Results
February 14, 2022

If you have ever gotten a hearing test, you may be familiar with what an audiogram is, but if you don’t, you’re not alone. An audiogram is a test that assesses your ability to hear.

The results of an audiogram are displayed as a graph, and if you aren’t familiar with how to properly read them, it can look like hieroglyphics. Your audiologist can help you to understand your results, but having a strong understanding of how to interpret them on your own can allow you to have more control over your own care.

Below is a closer look at everything you need to know about an audiogram, how to interpret its results, and what it can tell you about your hearing. 

Audiometry

To understand the results of an audiogram, it is important to understand how the entire test is conducted and the data that is being collected during the test.

Take a closer look at how an audiometer works and how the test is conducted below. 

How Does an Audiometer Work?

An audiometer is a device that is utilized to conduct a hearing test. The device consists of headphones worn by the patient, a computer that is able to generate sound signals at varying intensities and frequencies, and a control panel that is controlled by the physician. 

An audiometer works in a fairly simplistic manner. The audiologist will have you wear the headphones and will play a series of sounds at different tones with varying volumes. As the patient, your responsibility is to raise the hand of the same side that you hear the sound. If you hear a sound in your right ear, you would raise your right hand and vice versa. 

The audiologist will record your response each time a sound is played. If a sound is played but not heard by the patient, this is recorded and illustrates a lapse in your ability to hear. With an audiometer, not all sounds may be able to be perceivable. As such, the order tends to be randomized to maximize the accuracy of the test. 

Where Is the Test Conducted?

An important aspect of audiometry has to do with where the test is administered. Audiometry requires a specific set of environmental conditions to be met and of most importance is a lack of competing sounds. If you are getting a hearing test at an audiologist's office, they will likely have a dedicated quiet room with sound-deadening materials in the walls. This will eliminate outside competing noises. 

The main reason a quiet environment is necessary is that an audiometry test evaluates your ability to hear right at its minimum threshold. Having outside noise could make it difficult to hear those softer sounds or could even result in false responses on the part of the patient. A room being as quiet as possible reduces the chances of confounding variables and ensures the test is a true representation of your hearing ability. 

Who Conducts an Audiometry Exam?

There are many different medical professionals that can help to assess your hearing, but the only one that typically conducts an audiometry assessment is an audiologist. An audiologist is a medical professional that has a doctor of audiology degree (AuD).

The schooling for an audiologist includes a four-year post-graduate degree where they learn about the function of the ear, ear disorders, and the diagnostic methods available to help figure out the underlying causes for hearing and ear-related ailments. 

How To Read an Audiogram

During an audiometry exam, a large amount of data is collected, and simply looking at a series of frequencies and intensities is not a particularly helpful visual tool to understand how progressed someone's hearing loss is.

This is why upon completion of the test, the data is converted into a line graph. This graph will visually illustrate which sounds are difficult to hear and in which ear.

Below is a closer look at the components of the graph to further your ability to understand and read an audiogram. 

The X-Axis of the Graph

The x-axis of the graph will tend to be labeled as “frequency” or have a series of numbers followed by the unit of Hertz (Hz). Scientifically a hertz is a unit of frequency; it refers to the number of sound waves that pass a stationary point per second. While this most likely doesn’t mean much to you, it is basically the scientific way of illustrating pitch. 

Looking at the graph from left to right, the hertz value likely increases. What this means in terms of pitch is that lower pitch sounds will be closer to the left side of the graph. The higher pitch sounds will be found more to the right side of the graph.

With an audiometry test, they will typically test frequency ranges from 250 Hz to 8000Hz. This represents a majority of pitches that humans can hear — known as the critical hearing range

Y-Axis of the Graph

The Y-axis for an audiogram will typically be labeled as the hearing threshold in decibels (dB). Decibels are a measurement of sound intensity, and this is a quantifiable way of showing loudness. Your hearing threshold refers to the quietest sound you can hear, which is what is plotted on the audiogram graph. 

When you look at a typical audiogram, the quieter sounds have a lower dB and are found towards the top of the graph, while louder sounds are found the farther down you go with higher dB levels. 

The Key of the Graph

The key of a graph, also known as a legend, refers to the information that helps to clarify certain aspects of the data sets. During an audiometry test, both of your ears are assessed individually for their hearing ability.

When looking to plot these values, you could create two separate line graphs that illustrate the earring ability of each individual ear. But, it is often much easier to combine the two graphs and overlay the results in the same graph.

To distinguish the results of one ear from another, a key will most likely be used. The key will tell you which line represents which ear. This is important as it can tell you if one ear is worse off than another, and it can help you to understand which ear may be more troubled. 

Interpreting Results

Now that you understand the different components of the graph, you can start to put the pieces together to interpret your own audiogram. In most instances, an audiogram provided to patients will have predefined areas that span the horizontal of the graph that describe what the degree of hearing loss is present. 

When looking at the graph, the higher pitch sounds will be found farther to the right, and a decreased ability to hear that pitch will be present the farther a data point is to the y-axis. 

Hearing that is completely intact will have a hearing threshold below 20dB across all of the different pitches of sound and will almost resemble a straight line. Some variation may be present, but typically the trends will result in a horizontal line. 

With single-sided hearing loss, you will most likely see two very distinct lines and differences between the hearing ability of your ears. One ear may have completely intact hearing while the other may have a much higher threshold which essentially means a more difficult time hearing. 

Another common trend you may observe on an audiogram if you are older is a normal sense of hearing with lower frequency sounds but a decreased ability to hear higher-pitched sounds. This graph that resembles a downward sloping hill may be indicative of a condition known as presbycusis which is also referred to as age-related hearing loss

Hearing Aids

Understanding how to read an audiogram also gives you an increased insight into how hearing aids work. If hearing loss is determined by an audiogram, then the audiologist may recommend getting hearing aids.

Hearing aids are essentially devices that take incoming sounds and increase their intensity to fall within your hearing threshold. Certain hearing aids even have the ability to be programmed and only amplify the sounds of certain pitches. 

While prescription-grade programmable hearing aids are nice, they can carry hefty price tags and may require frequent assessment and adjustments by an audiologist. For the vast majority of people, over-the-counter hearing aids work just as well and can provide the same level of satisfaction. 

If you are in the market for hearing aids, check out Audien’s collection of hearing aids. With options available for nearly any budget and a money-back guarantee, you can shop with confidence. 

Reading Results

In summary, looking at an audiogram for the first time can be quite intimidating, but once you understand the individual components of the graph, it becomes much easier to interpret the results. Hopefully, this guide has given you the knowledge to understand more about your hearing and feel more empowered in your own healthcare. 


Sources

Hearing Screening Overview | Minnesota Department of Health

Audiometry screening and interpretation | NCBI

Audiometry - Clinical Methods | NCBI Bookshelf

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Drew Sutton M.D.

Drew Sutton, MD is a board-certified otolaryngologist. He has extensive experience and training in sinus and respiratory diseases, ear and skull base surgery, and pulmonary disorders. He has served as a Clinical Instructor at Grady Hospital Emory University for more than 12 years.

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