When you consult an audiologist, the doctor will ask questions regarding your medical history and often, directly refer you to receive an audiogram test. Audiogram tests are reliable and deliver highly accurate results for audiologists to interpret.
The article will explain what an audiogram is, delve into the nuances of audiogram tests, and provide information on the different hearing tests.
What Is an Audiogram Test
An audiogram test is a hearing test used to measure the hearing sensitivity of an individual, including the type and severity of hearing loss. The test is known as Pure Tone Audiometry and is considered the “gold” standard for testing hearing.
What is an Audiogram?
The term audiogram is defined as a graph that displays the results of an audiogram test. This graph will indicate how loud each frequency should be, in order for you to hear them. An audiologist’s interpretation of an audiogram will reveal the type and degree of hearing loss.
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How Is an Audiogram Hearing Test Completed?
An audiogram test is conducted in a soundproof room. The hearing care professional also known as an audiologist will present different sounds of varying frequencies and volumes using an instrument called an audiometer.
You will hear these sounds through earphones or speakers connected to the audiometer.
The audiologist will instruct you to raise your hand or press a button whenever you hear a sound. The lowest sound level that you can detect, at different frequencies, will be recorded on the audiometer.
A test called Speech Audiometry is often done, along with Pure Tone Audiometry. In Speech Audiometry, the audiologist will present speech signals instead of tones. There are two main types of tests in speech audiometry.
The first measures the speech level at which you can detect the presence of speech sounds. The second measures the speech level at which you can clearly understand speech.
Audiogram Y-Axis: Loudness or Intensity
In an audiogram, the lines that run from left to right indicate the frequency in Hertz or Hz. The lowest frequency is on the farthest left and the highest is on the right. The frequencies that are usually tested in audiometry are 125 Hz, 250 Hz, 500 Hz, 1000 Hz, 2000 Hz, 3000Hz, 4000 Hz, and 8000 Hz.
Audiogram X-Axis: Pitch or Frequency
The lines that run from top to bottom represent the loudness in decibels or dB. Soft sounds are at the top and loud sounds are towards the bottom. The intensity levels are shown in the audiogram range from -10 dB to 120 dB. The normal hearing range for humans is between 0 and 20 dB across all frequencies.
What Does an Audiogram Detect?
An audiogram detects the type, degree, and configuration of hearing loss.
Type of Hearing Loss
An audiogram test involves both air conduction and bone conduction testing. In air conduction testing, the sound vibrations travel through the air to the inner ear. In bone conduction testing, the sound signals will travel through the bone, via a bone oscillator, to the inner ear.
In other words, an audiogram test will determine whether or not the air conduction pathway or the bone conduction pathway, or both, are affected. This information is crucial in establishing the type of hearing loss.
The three main types of hearing loss are:
Ear blockages can lead to conductive hearing loss, damage in the inner ear or auditory nerve causing sensorineural hearing loss, or hearing loss made up of both these elements referred to as mixed hearing loss.
By determining the type of hearing loss, the audiologist can recommend the right treatment options.
Degree of Hearing Loss
The degree of hearing loss indicates the severity of hearing loss. A high degree of hearing loss means that you have severe hearing loss and your ability to hear is greatly reduced.
The varying degrees of hearing loss are: slight, mild hearing loss, moderate hearing loss, moderately severe, severe, and profound hearing loss.
An audiogram is used to measure the severity of hearing loss. This information is also necessary to plan appropriate treatment strategies. For instance, individuals with a high degree of hearing loss may not benefit from certain types of hearing aids.
Configuration of Hearing Loss
An audiogram will also reveal the pattern of hearing loss. Your hearing may be normal in low frequencies but be affected in high frequencies. In this case, you may find it difficult to understand speech.
Likewise, the audiologist will study the configuration of your hearing loss from the audiogram. This information is useful in programming hearing aids and other amplification devices.
Who Receives an Audiogram?
Anyone who suspects they are suffering from hearing loss can take an audiogram test to determine the presence or absence of hearing loss. The audiologist will interpret your audiogram to understand the exact type and degree of your hearing loss.
Babies cannot receive an audiogram as they will not be able to follow the instructions. Children above 3 years old can receive an audiogram test.
Where Can I Get an Audiogram?
To take an audiogram test, consult a licensed audiologist with a Doctor of Audiology (AuD) degree. Ask your general physician, friends, or family members to recommend an audiologist. Alternatively, you can visit the American Academy of Audiology website and search “find an audiologist”.
How to Prepare for an Audiogram?
There is no need to prepare before an audiogram test. All you need to do is listen carefully to the examiner’s instructions and give consistent responses during the test. Patient cooperation is important in an audiogram test to obtain accurate and reliable results.
How Long Does an Audiogram Take?
An audiogram test will take about 20 minutes, depending on the patient’s cooperation, the consistency of responses, and the examiner’s expertise. Children may take more time to complete the test due to the higher chance for inconsistent responses.
How Much Does it Cost for an Audiogram Test?
The cost of an audiogram test ranges from $56 to $90, depending on if you have medical insurance. Without insurance, an audiogram test can cost up to $250 depending on the clinic and practitioner.
Before booking an audiologist test, contact your insurance service provider and collect details about your insurance policy regarding hearing assessments. If you suspect hearing loss, inquire about the coverage for hearing aids as well.
Is Pure Tone Audiometry Accurate?
Pure tone audiometry is considered the gold standard for audiological evaluation because it provides highly accurate results. Audiologists prefer audiogram tests over other tests as they can clearly determine the type and extent of hearing loss using this test.
Pure tone audiometry tests for both air conduction and bone conduction pathways, thereby providing ear-specific information on the type of hearing loss. It also checks the hearing ability across a range of frequencies and measures the degree of hearing loss in each ear.
Pure tone audiometry is the most reliable test when getting a hearing examination.
Other Audiology Tests
Other than pure tone audiology, hearing evaluations consist of a few other tests.
Tympanometry is the test of the middle ear. Any obstruction in the middle ear can affect sound transmission. This test measures how well the eardrum moves in response to sound pressure.
The resulting graph, called a tympanogram, will help the examiner determine the presence of fluid or any other obstruction in the middle ear.
Otoacoustic Emissions (OAEs)
The OAE test assesses the function of your inner ear or cochlea. The hair cells in the inner ear vibrate in response to external sound. This vibration produces a faint sound which is referred to as the OAEs.
Individuals with normal hearing will produce OAEs, whereas hearing loss greater than 25-30 dB will result in absence of OAEs. Therefore, the OAE test can provide information on the function of hair cells and blockage in the middle and outer ear.
Auditory Brainstem Response (ABR)
An Auditory Brainstem Response is performed on individuals who are unable to complete a hearing screening. This test is also used if the underlying cause of hearing loss is connected to the brain.
ABR measures the brain’s response to sound. Electrodes are placed on the patient’s head and sounds are played through earphones. The test is painless and non-invasive.
An audiogram test is the most important test for evaluating hearing. The results from an audiogram clearly indicate the type, extent, and pattern of your hearing loss. This information is crucial for an accurate diagnosis and a proper treatment plan.