Exam
Audiogram
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Audiogram
, Audiometry, Pure-Tone Audiometry
See Also
Hearing Test
Hearing Impairment Severity Scale
Hearing Loss
Indications
Hearing Loss Evaluation
Preparation
Testing environment should be quiet
Patient should avoid loud noise exposure for 14 hours prior to testing (e.g. music via headphones, motorcycle)
Technique
Pure-Tone Audiometry
Threshold Search Audiometry (Hughson-Westlake Method)
Start with the better
Hearing
ear
Hearing
is tested in each ear at frequencies between 250 Hz to 8000 Hz
Frequencies tested at one octave intervals: 250 Hz, 500 Hz, 1000 Hz, 2000 Hz, 4000 Hz, 8000 Hz
Typical sequence: 1k, 2k, 3k, 4k, 8k, 1k, 500, 250
Each frequency is tested at volumes between 0-90 decibels (logarithmic, loudness doubles every 10 decibels)
Start with an easily heard DB level
Test each heard tone again at 10 DB lower until no response
Then increase by 5 DB, testing until tone heard again
Screening (typical handheld device)
Hearing
frequencies tested: 500 to 4000 Hz (speech spectrum)
Loudness tested: 25-30 DB in adults (15-20 DB in children)
Interpretation
Normal
Hearing
All frequencies are heard at 20 decibels or less
Hearing Loss
across all frequencies (typically 40 DB loss)
Conductive Hearing Loss
(e.g.
Cerumen Impaction
)
Otosclerosis
Low frequency
Hearing Loss
Meniere's Disease
(severe)
Low to mid-frequency
Hearing Loss
(with bone conduction better than air conduction)
Tympanic Membrane Perforation
High frequency
Hearing Loss
Noise-Induced
Sensorineural Hearing Loss
(4000 Hz and higher)
Age-Related Hearing Loss
-
Presbycusis
(2000 Hz and higher)
Efficacy
Handheld Audiometry for
Sensorineural Hearing Loss
(over age 5 years)
Test Sensitivity
: 92%
Test Specificity
: 94%
Resources
Audiogram of normal sounds
References
Walker (2012) Am Fam Physician 87(1): 41-7 [PubMed]
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