Reading an Audiogram

The Speech BananaAfter your hearing test is completed, the results will be displayed using a graph known as an audiogram. 



How to read an audiogram

An audiogram displays how well you can hear sounds of varying pitches. This information is represented using a graph. Along the horizontal axis, you will see a list of frequencies.  The frequencies will rise in pitch as you go from left to right. The vertical axis represents loudness, showing lower sound levels as you rise up the axis.

Therefore, if you have a point on your audiogram that is charted very high and far to the right side of the graph, you are able to hear a high pitched sound at a very soft volume. There will be points on the graph along all of the tested frequencies, showing the softest volume at which you were able to hear the tone.

The results for each ear will be represented on the audiogram. The left ear is represented by the letter X and the right ear is represented by the letter O. If a bone conduction threshold is recorded, these results will be represented by brackets [ and ].

 

What is the "speech banana" ?

The “speech banana” is the area on an audiogram where sounds commonly used during speech are found. As you can see in the picture provided above, this yellow shaded area on the graph forms a banana-like curve. Within the speech banana diagram, you can see where common sounds occur at normal conversational volume.

 

What you can learn from your audiogram

Once you understand how to read an audiogram, you must then be able to understand how to interpret the results. One of our hearing care professionals will help you read your audiogram, allowing you to better understand your hearing ability. When it comes to hearing loss, an audiogram can potentially provide the following information:

 

Type

  • Sensori-neural:  Your air and bone conduction thresholds are equal.
  • Conductive:  You only show signs of hearing loss from your air conduction thresholds. Your bone conduction thresholds show healthy hearing capabilities, meaning you may have a restriction in your middle or outer ear.
  • Mixed:  Both your air conduction and bone conduction thresholds show hearing loss, but the air conduction thresholds show a larger degree of loss.

 

Severity

By comparing your audiogram results to the ideal hearing range, you can determine the severity of your hearing loss. Normal hearing is generally considered to be around 20dB and above. The lower the points are on the graph, the more severe your loss.  


Slope

  • Sloping Loss:  Most audiograms show a sloping loss pattern, where the listener finds it harder to hear as the pitch increases in frequency. Due to ageing and noise exposure damage, people tend to experience a higher degree of hearing loss amongst the higher frequencies.
  • Flat Loss:  A flat loss means that the level of hearing loss is roughly equal amongst all frequencies.
  • Other Patterns:  Less commonly, audiograms can indicate a reverse slope pattern, in which there is greater hearing loss amongst the lower pitches, or irregular patterns amongst the frequencies.

 

How the ears compare

  • Binaural loss:  Each ear shows signs of hearing loss
  • Monaural loss:  Only one ear shows signs of loss
  • Asymmetrical:  One ear has experienced significantly more loss than the other
  • Symmetrical:  The level of hearing across each ear is relatively even


"If I'm only missing the higher frequencies, my hearing is OK..."

While it is always good to think positively, you do not want to misunderstand the results of your audiogram. Many people focus very heavily on the frequencies they can hear well, while discounting the frequencies that are giving them trouble. In reality, you must take the greater picture into consideration.

The Importance of Lower Frequencies:  Your ability to hear lower frequencies can affect your interpretation of the volume of speech. People with hearing loss in these areas may think others are always speaking too softly. Some people with problems hearing lower frequency sounds may speak too loudly themselves.

Significance of Higher Frequencies:  If hearing loss occurs amongst the higher frequencies, speech may become more difficult to understand. Certain verbal sounds, including “s”, “t”, “f”, “ph” and “th” sounds, are made using higher frequencies. Someone who has difficulty hearing high frequency sounds may feel that people often mumble. 

 

Examples of common audiograms

 

Audiogram for someone with presbycusis - hearing loss caused by age

Betty:  Betty's audiogram indicates a hearing loss known as presbycusis. As she has aged, she has experienced greater levels of hearing loss amongst her higher frequency sounds.  This makes it more difficult to hear people speak, especially when having conversations with her young grandchildren.

Before being fitted with custom hearing aids, Betty experienced trouble hearing people over the telephone.  Talking in noisy restaurants and other crowded areas was also difficult. Betty's type of hearing loss is very common amongst the older generation.
 

   
Audiogram for someone with noise induced hearing loss

Bob:  Bob's audiogram is an example of what happens to your hearing if you are constantly subjected to high levels of noise.  He has been working as a carpenter for over 4 decades and admits to rarely wearing ear protection.

As Bob has been working in close proximity to loud squealing circular saws, his hearing has experienced a sharp decline in the high frequency region. He will have to take greater care around loud equipment to ensure his hearing doesn’t decline further.  As a result of the damage caused to his ears, he will require hearing devices to understand what people are saying.

 

   
Audiogram showing a conductive hearing loss

Jeremiah:  As you can see, Jeremiah’s audiogram shows a slope that is almost completely level, with the air conduction results significantly higher than the bone conduction results. These results show that Jeremiah has a conductive hearing loss and that his inner ear is quite healthy.

Jeremiah is suffering from an illness or infection, which is causing fluid to build in his middle ears. He likely feels pressure and tightness within the ear. Once this condition is alleviated properly, sound will once again be able to easily pass through the middle ear to the cochlea.

 

 

Free hearing appointment

Call 5443 6633 between 8:30 am and 4:30 pm, Monday to Friday to book your free, no obligation hearing appointment. The free hearing appointment is valid for people aged 55 years or older.  We have clinics located throughout the Sunshine Coast at Maroochydore, Buddina, Caloundra, Cooroy, Noosa Heads and Nambour.  We also have a clinic at Gympie.