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Understanding Audiograms: Measuring Hearing and Interpreting Results, Slides of Communication

An overview of audiology, focusing on the measurement of hearing through audiograms. It explains the procedure for gathering hearing information, the significance of frequencies and decibels on an audiogram, and the concepts of air and bone conduction testing and masking. The document also introduces audiometric symbols and their interpretation for determining the degree and type of hearing loss.

Typology: Slides

2021/2022

Uploaded on 09/12/2022

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Audiology
The Measurement of Hearing
Hearing is measured by determining how well a person can hear a range of
frequencies of sounds. There is a specific procedure used to gather this
information, which then is generally plotted on a graph called an audiogram.
Below is a sample audiogram form:
Across the top of the audiogram are numbers representing various
frequencies of sounds that are typically tested. Low frequency sounds are
represented on the left side of the audiogram, while high frequencies are on
the right. Frequencies are measured in hertz (Hz), or kilohertz (KHz). This
audiogram form depicts frequencies in KHz. The range of frequencies on the
audiogram corresponds to the range of frequencies most needed for verbal
communication purposes. Occasionally intermediate frequencies of 0.75, 1.5,
3 and 6 KHz may also be tested and plotted.
Going from the top to the bottom of the audiogram is the intensity scale in
decibels (dB). “ISO” refers to the International Standards Organization which
is a worldwide association that sets standards for a wide range of physical
measurements. Softer sounds are represented at the top of the audiogram,
while loud sounds are at the bottom. The actual values plotted on an
audiogram at the different frequencies are called thresholds. A threshold is
defined as the intensity at which a person can hear a specific sound 50% of
the time. There is a standardized procedure to determine thresholds.
Generally an audiogram will show the hearing results for both the right and left
ears. As such there are different symbols used to differentiate the hearing
results for each ear. However, before proceeding with this topic, two other
concepts need to be introduced.
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Audiology

The Measurement of Hearing

Hearing is measured by determining how well a person can hear a range of frequencies of sounds. There is a specific procedure used to gather this information, which then is generally plotted on a graph called an audiogram. Below is a sample audiogram form: Across the top of the audiogram are numbers representing various frequencies of sounds that are typically tested. Low frequency sounds are represented on the left side of the audiogram, while high frequencies are on the right. Frequencies are measured in hertz (Hz), or kilohertz (KHz). This audiogram form depicts frequencies in KHz. The range of frequencies on the audiogram corresponds to the range of frequencies most needed for verbal communication purposes. Occasionally intermediate frequencies of 0.75, 1.5, 3 and 6 KHz may also be tested and plotted. Going from the top to the bottom of the audiogram is the intensity scale in decibels (dB). “ISO” refers to the International Standards Organization which is a worldwide association that sets standards for a wide range of physical measurements. Softer sounds are represented at the top of the audiogram, while loud sounds are at the bottom. The actual values plotted on an audiogram at the different frequencies are called thresholds. A threshold is defined as the intensity at which a person can hear a specific sound 50% of the time. There is a standardized procedure to determine thresholds. Generally an audiogram will show the hearing results for both the right and left ears. As such there are different symbols used to differentiate the hearing results for each ear. However, before proceeding with this topic, two other concepts need to be introduced.

Air and Bone Conduction Testing: Air and bone conduction testing is used to establish the type of hearing loss present. A hearing loss can be sensorineural, conductive or mixed. Air conduction testing is done using standard earphones, although sometimes an insert phone is used. Basically, air conductive testing assesses the outer, middle and inner ear as a unit. On the other hand, bone conduction testing uses a bone vibrator, which is placed on the mastoid prominence behind the pinna. The bone vibrator transmits sounds to the bones of the skull, which in turn stimulate the inner ear directly. Basically, bone conduction testing assesses inner ear function. Comparison of the air and bone conduction thresholds is used to determine the type of hearing loss.

There are three types of hearing loss, sensorineural, conductive and mixed. By definition, a sensorineural hearing loss is present if there is less than a 15 dB difference between the air and bone conduction thresholds of a given ear, and the air and bone conduction thresholds are worse than 15 dB. A conductive hearing loss is defined by bone conduction thresholds being 15 dB or better than the air conduction thresholds, and the bone conduction thresholds are 15 dB or less. And a mixed loss will have both conductive and sensorineural components in the loss. Following are sample audiograms illustrating sensorineural, conductive and mixed hearing losses. Sensorineural hearing loss: Moderate to severe sensorineural hearing loss

Conductive hearing loss: Mild to moderate conductive loss Mixed hearing loss: Moderately severe to profound mixed loss