Fig 1: A hearing test is used to measure the softest sounds that a person can hear at different frequency levels and is plotted on an Audiogram where the resulting graph is laid out similar to a piano keyboard with low to high Frequencies on the horizontal ‘X’ axis going from left (low) to right (high) and Volume on the vertical ‘Y’ axis starting very quietly at the top becoming louder nearer the bottom.


Fig 2: The first part of a hearing evaluation is called an Air Conduction test where typically, a pure tone stimulus is presented to one ear at a time either via headphones or insert tips over a range of frequencies and decibel (dB) levels and the patient responds each time a signal is heard. The corresponding results are plotted on the audiogram with a Red ‘O’ representing the Right ear and a Blue ‘X’ denoting the Left ear.
Fig 3: Following the Air Conduction testing, a Bone Conduction test is carried out using an oscillator to present the stimulus to the Mastoid bone (the bony protrusion behind the ear). These results are graphed with either a Triangle in Red for the right and/or a Blue Triangle for the left or a right facing Bracket ‘[‘ for the right and a left facing Bracket ‘]’ for the Left depending on the type of test being conducted.

In the example above Fig 3, the graph is showing a Mild to Severe Bilateral (both ears) High Frequency Sensorineural Hearing Loss in both ears. The Sensorineural description is given because the Bone Conduction readings are similar to the Air Conduction results. If there was a significant gap between the Air and Bone readings the loss would be described as Conductive and can be indicative of an outer or middle ear disorder. A Sensorineural loss refers to a problem associated with the Inner ear and generally indicates Nerve damage to the Inner ear hair cells.