II. Indications
III. Preparation
- Patient should avoid loud noise exposure for 14 hours prior to testing (e.g. music via headphones, motorcycle)
- Testing environment should be quiet
- Formal audiology evaluations are typically performed in a sound proof booth
- Testing varies by indication
- Clinic Hearing screening is often performed with a handheld device (or online/webapp)
- Threshold search Audiometry may be used to program Hearing Aids
- Comprehensive Audiometry differentiates between conductive, sensorineural and mixed Hearing Loss
IV. Technique: Pure-Tone Audiometry
- 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)
- Threshold Search Audiometry (Hughson-Westlake Method, by audiologist)
- 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
- Comprehensive Audiometry (by audiologist, typically in a sound proof room)
- Air and bone testing differentiates conductive, sensorineural and mixed Hearing Loss
- Pure tone air conduction via headphones
- Pure tone bone conduction via device applied to mastoid bone
- Tympanometry
- Speech-reception threshold and word recognition
- Air and bone testing differentiates conductive, sensorineural and mixed Hearing Loss
V. Findings: Audiogram Graph
- Images
- Audiogram axes
- Horizontal (X-Axis): Increasing frequencies (Hertz) from left to right
- Vertical (Y-Axis): Increasing sound intensity (decibels) from soft (top) to loud (bottom)
- Thresholds
- Softest sound heard per frequency 50% of the time is recorded as threshold on the graph
- Symbols
- Four symbols are used (2 for air L/R, 2 for bone L/R)
- For each frequency, these 4 symbols are plotted, representing thresholds (left and right ears, air and bone)
- Interaural Attenuation
- Sound waves lose acoustic energy as they travel transcranially to the contralateral ear
- In Hearing Testing, soft sounds are not typically heard by the opposite ear
- Cross Hearing
- Good ear detects sounds presented only to the bad ear despite interaural attenuation
- Results in False Negative testing of the bad ear
- Overcome by masking procedure
- Cross Hearing occurs when there is a large threshold discrepancy between ear Hearing thresholds
- Bad ear threshold exceeds the good ear threshold by >40 dB (55 dB for insert earphones)
- Loud sounds presented to bad ear overcomes interaural attenuation
- Good ear detects sounds presented only to the bad ear despite interaural attenuation
- Masking
- When testing the "bad" ear, noise is presented to the "good" ear to block cross Hearing
VI. Interpretation
- Normal Hearing
- All frequencies are heard at 20 decibels or less
- Hearing Loss across all frequencies (typically 40 DB loss)
- Low frequency Hearing Loss
- Meniere's Disease (severe)
- Low to mid-frequency Hearing Loss (with bone conduction better than air conduction)
- High frequency Hearing Loss
- Noise-Induced Sensorineural Hearing Loss (4000 Hz and higher)
- Age-Related Hearing Loss - Presbycusis (2000 Hz and higher)
VII. Efficacy: Handheld Audiometry for Sensorineural Hearing Loss (over age 5 years)
- Test Sensitivity: 92%
- Test Specificity: 94%
Images: Related links to external sites (from Bing)
Related Studies
| Definition (NCI_CDISC) | Testing conducted utilizing a manual or microprocessor audiometer to test for hearing loss. |
| Definition (NCI) | Testing conducted utilizing a manual or microprocessor audiometer to test for hearing loss. |
| Definition (MSH) | The testing of the acuity of the sense of hearing to determine the thresholds of the lowest intensity levels at which an individual can hear a set of tones. The frequencies between 125 and 8000 Hz are used to test air conduction thresholds and the frequencies between 250 and 4000 Hz are used to test bone conduction thresholds. |
| Definition (PSY) | Specific procedures or audiometric tests used to measure hearing acuity and range in the diagnosis and evaluation of hearing impairments. Consider also AUDIOLOGY and SPEECH AND HEARING MEASURES. |
| Definition (CSP) | specific test to measure the acuity of the sense of hearing to determine the thresholds of the lowest intensity levels at which an individual can hear a set of tones; frequencies between 125 and 8000 Hz are used to test air conduction thresholds and the frequencies between 250 and 4000 Hz are used to test bone conduction thresholds. |
| Concepts | Diagnostic Procedure (T060) |
| MSH | D001299 |
| ICD9 | 95.41 |
| SnomedCT | 141925003, 34091002, 277300001, 164760009, 21727005 |
| English | Audiometries, audiometry (procedure), audiometry, Hearing Test, Test;audiometry, audiometric testing, audiometry tests, Electrical tracings;ear, audiometric test, audiometry testing, Audiometry (procedure), AUDIOMETRY, Audiometric test, Audiometric test (procedure), Audiometric test, NOS, Audiometry, NOS, Audiometric Test, Audiometry, audiometry test |
| Dutch | audiometrie, audiometrische test, Audiometrie |
| Italian | Prove audiometriche, Audiometria |
| Portuguese | Prova audiométrica, Audiometria |
| Spanish | Prueba audiométrica, audiometría (procedimiento), audiometría, prueba audiométrica, Audiometría |
| Japanese | 聴力検査, ﾁｮｳﾘｮｸｹﾝｻ |
| Swedish | Hörselmätning |
| Czech | audiometrie, Audiometrický test, Audiometrie |
| Finnish | Audiometria |
| Russian | AUDIOMETRIIA, АУДИОМЕТРИЯ |
| Croatian | AUDIOMETRIJA |
| Polish | Audiometria |
| Hungarian | Audiometriás vizsgálat, Audiometria |
| Norwegian | Audiometri, Hørselsmåling |
| French | Audiométrie |
| German | Audiometrie, Gehörprüfung, Hörprüfung |
Ontology: Audiometry, Pure-Tone (C0004292)
| Definition (MSH) | Measurement of hearing based on the use of pure tones of various frequencies and intensities as auditory stimuli. |
| Concepts | Diagnostic Procedure (T060) |
| MSH | D001301 |
| SnomedCT | 252577008 |
| English | Audiometry, Pure Tone, Audiometry, Pure-Tone, Pure-Tone Audiometry, pure tone audiometry, pure-tone audiometry, PTA - Pure tone audiometry, Pure tone audiometry, Pure tone audiometry (procedure) |
| Swedish | Tonaudiometri |
| Czech | audiometrie čistými tóny |
| Finnish | Äänesaudiometria |
| Russian | AUDIOMETRIIA BEKESHI, AUDIOMETRIIA TONAL'NAIA, АУДИОМЕТРИЯ БЕКЕШИ, АУДИОМЕТРИЯ ТОНАЛЬНАЯ |
| French | Audiométrie tonale liminaire, Audiométrie tonale |
| Polish | Audiometria czystego tonu |
| Norwegian | Toneaudiometri, Rentoneaudiometri, Reintoneaudiometri |
| Spanish | audiometría tonal (procedimiento), audiometría tonal, Audiometría de Tonos Puros |
| German | Audiometrie, Reinton- |
| Italian | Audiometria del tono puro |
| Dutch | Audiometrie, pure toon-, Toonaudiometrie, Toonaudiometrie, pure |
| Portuguese | Audiometria de Tons Puros |
Ontology: Hearing Tests (C0018786)
| Definition (NCI) | A graphic record of the softest sounds that a person can hear at various frequencies, used to measure hearing loss. |
| Definition (CSP) | a general term for the measurement of hearing. |
| Concepts | Diagnostic Procedure (T060) |
| MSH | D006320 |
| ICD9 | 95.42, 95.47 |
| SnomedCT | 34091002, 141914007, 148632000, 164745006, 398171003, 252575000, 32921008, 398280008 |
| English | Hearing Tests, Hearing Test, Test, Hearing, Tests, Hearing, examination of hearing, examination of hearing (physical finding), hearing, hearing exam, Clinical hearing test, Hearing examination NOS, clinical hearing tests, hearing tests, audiograms, exams hearing, Test;hearing, auditory tests, hearing test, auditory test, audiogram, hearing testing, auditory testing, hear test, hearing examination, Individual hearing examination (procedure), Hearing test, Hearing examination, Clinical test of hearing, Auditory testing, Individual hearing examination, Audiogram, HT - Hearing test, Hearing examination (procedure), Audiogram (procedure), Auditory acuity evaluation (procedure), Auditory acuity evaluation, Auditory testing (procedure), Hearing examination, NOS, Clinical test of hearing, NOS, Auditory acuity evaluation, NOS, Audiogram, NOS, Hearing examination, not otherwise specified |
| Italian | Audiogramma, Test dell'udito, Esami audiometrici |
| Dutch | gehoortest, audiogram, Gehoortest, Gehoortests, Test, gehoor- |
| German | Hoertest, Audiogramm, Hörprüfungen, Hörtests |
| Portuguese | Prova de audição, Audiograma, Testes Auditivos |
| Spanish | Prueba de audición, evaluación de la agudeza auditiva, examen de la audición (procedimiento), prueba clínica de la audición, examen de la audición, Tests Auditivos, audiograma (procedimiento), audiograma, evaluación de agudeza auditiva (procedimiento), evaluación de agudeza auditiva, examen audiológico (procedimiento), examen audiológico, prueba auditiva (procedimiento), prueba auditiva, Audiograma, Pruebas Auditivas |
| Japanese | 聴力図, 聴覚検査, ﾁｮｳｶｸｹﾝｻ, ﾁｮｳﾘｮｸｽﾞ |
| Swedish | Hörseltester |
| French | Test d'audition, Tests de l'audition, Tests auditifs, Audiogramme |
| Czech | sluchové testy, Test sluchu, Audiogram |
| Finnish | Kuulokokeet |
| Russian | SLUKHOVYE TESTY, СЛУХОВЫЕ ТЕСТЫ |
| Croatian | SLUH, ISPITIVANJE |
| Polish | Badanie słuchu, Testy słuchu, Próby słuchowe |
| Hungarian | Audiogram, Hallás vizsgálat |
| Norwegian | Hørselsprøver, Hørselstester |
