An audiogram is the graph we use to diagnose and monitor hearing loss. It’s created by finding the softest sounds you can hear (your “thresholds”) across a range of frequencies, and plotting them. The results help guide everything from hearing-aid fitting to medical and surgical decisions.
How the test works
During pure-tone audiometry, the audiometer plays tones at different frequencies and volumes, from low to high. Your ability to hear each tone is plotted to create the audiogram. With children, the method is matched to their age:
- Otoacoustic emissions (OAE): tests the inner-ear hair cells — often used as a newborn screen.
- Auditory brainstem response (ABR): uses sensors to monitor the brain’s response to sound; suitable at any age.
- Behavioural observation (0–5 months): observing a baby’s response to sound.
- Visual reinforcement audiometry (6 months–2 yrs): the child turns toward a sound paired with a visual reward.
- Conditioned play audiometry (2–5 yrs): the child performs a fun action in response to sound.
- Conventional audiometry (5 yrs+): raising a hand or pressing a button when a tone is heard.
Degrees of hearing loss
Your average thresholds place your hearing in one of these categories:
| Threshold (dB HL) | Degree of hearing loss |
|---|---|
| 0–25 (adults) · 0–15 (infants) | Normal hearing |
| 26–40 | Mild |
| 41–55 | Moderate |
| 56–70 | Moderately severe |
| 71–90 | Severe |
| 91 and above | Profound |
Types of hearing loss
Hearing loss generally falls into two types, which can also occur together as a “mixed” loss:
Conductive hearing loss
This happens when sound can’t be conducted efficiently through the outer or middle ear — for example due to ear-wax impaction, a perforated eardrum, fluid in the middle ear, or otosclerosis. Conductive losses are more often correctable with medical or surgical treatment. Tuning-fork tests (Rinne and Weber) and tympanometry help identify them.
Sensorineural hearing loss (SNHL)
SNHL occurs when there’s damage to the inner ear or the nerve pathways to the brain. It’s the most common type of permanent hearing loss, and chronic noise exposure is a frequent cause. Other causes include ageing (presbycusis), certain infections, ototoxic medications, head trauma and, rarely, tumours. SNHL is usually managed very effectively with hearing aids.
Reading the graph
On an audiogram, frequency runs along the horizontal axis and loudness (threshold) down the vertical axis. The right ear is typically marked with an “O” and the left with an “X”, and bone-conduction results are added so we can tell conductive and sensorineural loss apart. Related measures you may see include the speech reception threshold (SRT), word recognition score, acoustic reflexes and tympanometry types (A = normal, B = flat, often fluid; C = negative middle-ear pressure).
Get your hearing explained, clearly
The best way to understand your hearing is to have an audiologist walk you through your own audiogram. Book a consultation in Viman Nagar and we’ll explain exactly what your results mean — and what (if anything) to do next.