Understanding Your Audiogram - How to Read Hearing Test Results

An audiogram is the most important document in your hearing health journey. It is the chart produced after a Pure Tone Audiometry (PTA) hearing test, showing exactly how well you hear at different frequencies. Yet most patients receive their audiogram and have no idea what those lines, circles, and crosses actually mean.

At our clinic in Islamabad, we take time to explain every audiogram in detail. This guide will help you understand yours before your next visit.

The Two Axes of an Audiogram

Every audiogram has two axes. Understanding them is the first step to reading your results.

Horizontal Axis - Frequency (Pitch)

The horizontal axis shows frequency measured in Hertz (Hz), typically ranging from 250 Hz to 8000 Hz. Low frequencies (250-500 Hz) represent deep sounds like a drum or a male voice. High frequencies (4000-8000 Hz) represent sharp sounds like birds chirping, children speaking, or the consonants S, F, and TH.

Vertical Axis - Intensity (Loudness)

The vertical axis shows intensity measured in decibels (dB), ranging from -10 dB at the top to 120 dB at the bottom. The softer the sound you can detect, the higher your mark appears on the chart. Normal hearing falls between -10 dB and 25 dB across all frequencies.

Symbols on the Audiogram

Audiologists use standardized symbols to mark results:

• O (Red Circle): Right ear air conduction thresholds
• X (Blue Cross): Left ear air conduction thresholds
• < and > Brackets: Bone conduction thresholds, which help determine whether hearing loss is conductive or sensorineural
• S or Sound Field: Results measured with speakers rather than headphones, often used for young children

Degrees of Hearing Loss

Based on where your marks fall on the audiogram, your hearing loss is classified into the following categories:

• Normal Hearing (0-25 dB): No hearing aid needed
• Mild Loss (26-40 dB): Difficulty hearing soft speech; a basic hearing aid can help significantly
• Moderate Loss (41-55 dB): Difficulty with normal conversation; a mid-range hearing aid is recommended
• Moderately Severe (56-70 dB): Speech must be loud to be heard; a powerful hearing aid is essential
• Severe Loss (71-90 dB): Only very loud sounds are heard; a Super Power BTE is typically required
• Profound Loss (91+ dB): Almost no sound is perceived; Ultra Power devices or cochlear implants may be considered

Types of Hearing Loss Revealed by the Audiogram

Sensorineural Hearing Loss

When both air and bone conduction thresholds are equally reduced, the inner ear or auditory nerve is damaged. This is the most common type in older adults and is permanent. Hearing aids are the primary treatment.

Conductive Hearing Loss

When air conduction is poor but bone conduction is normal, there is a blockage or problem in the outer or middle ear. This can sometimes be treated medically or surgically.

Mixed Hearing Loss

A combination of both types, where both air and bone conduction are affected but air conduction is worse. Treatment may involve both medical intervention and hearing aids.

What Your Audiogram Means for Hearing Aid Selection

Your audiogram directly determines which hearing aid model is right for you. A mild high-frequency loss might only need a small RIC device, while a severe flat loss requires a powerful BTE. Our audiologists use your audiogram to program your Signia hearing aid precisely, ensuring each frequency is amplified by the exact amount you need.

Without a current audiogram, no hearing aid can be properly fitted. This is why we always recommend starting with a professional hearing test at our clinic.