About Hearing
Your Audiogram Explained
An audiogram is the chart you receive after a hearing test. It shows the softest sounds you can hear at each pitch. Here is how to read yours.
Explore an audiogram
Choose an example to see how different types of hearing loss look on the chart, then tap the coloured bands to see what each degree can mean.
Choose an example audiogram
- ORight ear, air conduction
- XLeft ear, air conduction
- <Right ear, bone conduction
Normal hearing
Both ears hear soft sounds across all pitches. The marks sit near the top of the chart, in the normal range.
High-frequency loss
Hearing is close to normal for low pitches but drops for high pitches. Speech may sound loud enough but unclear, because many consonants, such as s and f, are high-pitched. Air and bone conduction marks sit together, which points to sensorineural hearing loss.
Conductive loss
Air conduction marks are lower than bone conduction marks in the right ear. This gap, called the air-bone gap, shows that sound is not passing well through the outer or middle ear, while the inner ear works well.
Mixed loss
Both air and bone conduction marks are lower than normal, and there is still a gap between them. This means there is a problem in the inner ear and in the outer or middle ear at the same time.
Single-sided deafness
One ear hears normally while the other has profound hearing loss. Conversations in quiet may be easy, but noise and finding where sounds come from can be hard.
Degrees of hearing loss
Tap or hover over a coloured band on the chart to see what each degree of hearing loss can mean in daily life.
Normal: 0 to 20 dB
Soft sounds, such as a dripping tap or birds chirping, are heard.
Mild: 21 to 40 dB
A normal voice (about 65 dB) is heard, but a ticking clock, a dripping tap or softer speech sounds may be missed.
Moderate: 41 to 70 dB
Normal conversation may not be understood, and a phone ringing may be missed.
Severe: 71 to 90 dB
Loud conversation or traffic may not be heard.
Profound: 91 dB or more
Aeroplane engines, trucks or fire alarms may not be heard.
These example audiograms are for illustration only. Degrees follow MED-EL’s scale. Your own audiogram will be different, and your audiologist will explain it.
How to read the chart
Pitch, from left to right
Frequency is measured in hertz (Hz), usually from 125 Hz to 8000 Hz. Low pitches, such as a dog barking or a lawnmower, are on the left. High pitches, such as birdsong or a child’s squeal, are on the right.
Loudness, from top to bottom
Hearing level is measured in decibels (dB HL). Soft sounds are at the top and loud sounds at the bottom. The lower a mark sits, the louder a sound had to be before you heard it.
Right and left ears
A red O usually marks the right ear and a blue X the left ear. Your audiologist may also test bone conduction, shown with symbols such as < and >.
Audiogram symbols
These are the most common symbols. Clinics may use slightly different ones, so ask your audiologist if something is not clear.
| Symbol | Meaning |
|---|---|
| O | Right ear, air conduction |
| X | Left ear, air conduction |
| △ | Right ear, air conduction with masking |
| □ | Left ear, air conduction with masking |
| < | Right ear, bone conduction |
| > | Left ear, bone conduction |
| [ | Right ear, bone conduction with masking |
| ] | Left ear, bone conduction with masking |
| Arrow pointing down | No response at the loudest level tested |
Degrees of hearing loss
This scale follows MED-EL. ASHA uses a slightly different scale with more bands, and some professionals set the limit of normal hearing at 15, 20 or 25 dB.
| Degree | Hearing level | What it can mean |
|---|---|---|
| Normal | 0 to 20 dB | Soft sounds, such as a dripping tap or birds chirping, are heard. |
| Mild | 21 to 40 dB | A normal voice (about 65 dB) is heard, but a ticking clock, a dripping tap or softer speech sounds may be missed. |
| Moderate | 41 to 70 dB | Normal conversation may not be understood, and a phone ringing may be missed. |
| Severe | 71 to 90 dB | Loud conversation or traffic may not be heard. |
| Profound | 91 dB or more | Aeroplane engines, trucks or fire alarms may not be heard. |
Air conduction, bone conduction and the gap between them
Air conduction tests use headphones, so sound travels through the whole ear. Bone conduction tests use a small vibrator behind the ear, which skips the outer and middle ear. Comparing the two shows the type of hearing loss.
Air and bone conduction marks are both lower than normal and sit close together, with little or no gap.
Bone conduction is better than air conduction. This difference, called the air-bone gap, shows a problem in the outer or middle ear.
Both air and bone conduction are lower than normal, and there is still a gap between them.
The “speech banana”
The sounds of speech fall in a banana-shaped area of the audiogram, roughly 250 to 4000 Hz and 20 to 60 dB (ASHA). If your marks fall below this area, parts of speech may be hard to hear. ASHA notes that each language has its own speech banana, so the exact shape for Arabic is not the same as for English.
Questions about audiograms
On MED-EL’s scale, 0 to 20 dB is normal. ASHA uses a stricter limit of 15 dB and notes that some professionals use 20 or 25 dB.
Lower marks mean a sound had to be louder before you heard it, so marks lower on the chart mean poorer hearing at that pitch.
A red O usually marks your right ear and a blue X your left ear, both tested through headphones (air conduction).
It is the difference between your air conduction and bone conduction results. A clear gap points to conductive or mixed hearing loss.
It shows the type and degree of hearing loss and helps identify a suitable solution (MED-EL). Your audiologist will combine it with speech tests and your daily needs before recommending an option.
Sources: MED-EL: The audiogram · ASHA: Audiograms and hearing loss configuration · ASHA: Degree of hearing loss · ASHA: Audiogram symbols guideline
This page is for general information only and is not medical advice. Please see an ENT doctor or audiologist for advice about your own hearing.
Want your audiogram explained?
Book a hearing test at Harmony, and our audiologists will go through every mark on your audiogram with you.