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What is an Audiogram and How Does it Work?

Learn how hearing loss is measured, and how the amount and type of hearing loss is shown visually on an audiogram.



The audiogram, what is it? And how does it work? That's our topic today on ask the hearing doctors


Hi, I'm Jim Cuddy, and this is Ask The Hearing Doctors, and today I'm joined by Dr. Ana Anzola, Dr. Wendy Thorne, doctors of audiology with Hearing Doctors, the Washington DC area is highest rated audiology practice with over 1500 five-star reviews. Anna, Wendy has always great to see you both. So today we're going to talk about and learn about the audio ground. But before we do that, let's talk about how hearing loss is measured. 


Yeah. There's a couple of ways that we measure that, that first one is always going to be the degree of hearing loss that goes anywhere from normal, meaning no hearing loss down to profound in between there there's also different measurements for mild, moderate, and severe, and then the type it could be conductive. It can be sensorineural, it could be mixed, um, or even central. 


Well, all right. So take me through the process. When I come in, how do we go about where, where do I go to get my ears tested? 


Yeah. So after we've, you know, gone over the case, history looked in your ears. The first place you're going to go is into our sound booth. Um, that's where you're going to wear the ear phones. And that's where the whole testing process began. 


And what are you looking for? So what you're looking for and what comes out of that is the audio audiogram, right?


So the auditorium is a piece of a measurement tool that we have, so we can measure somebody's hearing sensitivity. And so there's a way to read it. And the way it's read is you're going to find, um, on the X axis, um, different tones or pitches that you're able to hear from very low tones to the very high pitch tones and on the Y then you'll find degrees. So from the soft, all the way to the loud, and so measuring some type of degree, normal, mild, moderate, moderately, severe, severe, or profound, yeah. At each of those tones, we're trying to find the softest level of hearing that you can hear. And that's how we're able to plot that and see the configuration of your hearing. 


Ah, okay. Now you mentioned three different types of hearing loss. Can you talk about each of those, let's start with conductive. 


So conductive, um, so you have three parts to every year, the outer ear, the middle ear, and then the inner ear. So if there's a blockage or something in malfunction, um, in the outer or the middle ear, you will have some sort of separation between what we call a bone conduction measurement versus an air conduction measurement. So the air conduction is either the insert that you actually wear in the ear, traveling the signal, the sound traveling through all three years versus the bone conduction that tends to then bypass the outer, the middle, and then the inner ear. So separating all three, and then we're able to figure out which ear has the problem or the site of lesion. Is that the outer, the middle or the inner ear. 


And that leads you to which type of, of loss that, that somebody has. Yeah. 


Yeah. Different examples of like a conductive hearing loss would be like wax occlusion, um, middle ear infections, outer ear infections, or there are some different, um, illnesses or diseases that kind of affect those middle ear bones where they're either not formed properly or they break or different things like that. So as the signal is gonna travel through the ear, so let's say you were wearing the little insert, so that blockage is going to slow down the signal. So you will end up with lower scores in certain regions, like the low tones, but then the bone conduction will appear as being normal. So that big separation between the air conduction and the bone conduction will tell us, Oh, there's gotta be some blockage, outer ear, middle ear. 


So you're looking at each of those lines and trying to determine, okay, what specifically I would need if this is me, uh, in terms of, of hearing aid, right. 


And, and that, and actually that would be the easiest thing. Um, um, those are easily, um, treat it surgically. Um, either if it's wax, let's take it out. If it's a malfunction of the, um, middle ear bones, they can be fixed and those are, um, easily treatable. 


Okay. Now let's talk the next one, uh, sensorineural. Yeah. Describe that for us. 


So that would be, um, where Dr. Anzola was talking about the different levels of hearing. So that's usually meaning the outer ears functioning. Well, the middle ear is functioning well, but it's something within the inner ear is not functioning as well. So the sound goes through everything until it gets to the inner ear. And it's either, you know, the cochlea, the hair cells or the nerves are not transmitting the sound up to the brain as well as it's showing. Okay. Typically we treat that through, um, some sort of hearing device or amplifications. 


Okay. So what I would refer to as just a common hearing aid, right? Yeah. Okay. All right. And then last mixed is, is it what it sounds like? Is it the two other two combined together? 


Exactly. So this is a problem to both the outer or the middle and or the inner ear. So it's the combination of the two 


Or one of these more common than the other? 


Well, it's definitely the sensory neural hearing loss is the most common hearing loss that we tend to see through our doors. 


Sweet. And is that, is that just in other words, somebody is getting older, their hearing starts to go, is that typically sensorineural? 


Most often? Yeah. If anything, conductive or mixed, there's usually another medical condition that's contributing to that part of it. So it's about 95% of the population will have some sort of, um, sensory neural hearing loss in about 5% of the population will have some sort of a medical issue that can be easily treated. All right. And the conductive hearing loss. Right. 


Right. As far as the, the different degrees, when you mentioned profound, I'm assuming profound is probably the worst. Um, what are the different solutions for each of those? You know, when, when you come in and somebody has profound hearing loss or where somebody has moderate hearing loss, what are the different solutions or is it not the same for everybody? 


So it's a little similar among all the degrees. You know, the more hearing loss you have typically you need a more powerful device. So someone with a severe profound hearing loss is not going to be able to do as small, tiny device. Um, but usually, I mean, it's always going to be hearing aidsis typically going to serve all of those different conditions, mild to profound. But if, um, if it's mostly profound, so it's a very powerful hearing aid or hearing device, or we move over to more like a cochlear implant. 


Ah, okay. Now is that, and that's something you would refer out to 


That's where we refer out typically to a surgeon or an ENT, um, where they're very specialized in that type of, um, hearing device. 


That's fascinating because I think the, the, you know, hearing healthcare, healthcare professionals, um, audiologists like yourselves, you're able to do so much more for people now than probably even 10 or 15 years ago than ever before. Yes, of course. 


That's fantastic. Thank you both very much. That's great information. Thank you. If you're in the Washington metropolitan area and you'd like to schedule an appointment with Hearing Doctors, click the link in the description or visit

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