Download Understanding Your Audiogram and the Types of Hearing Loss

UNDERSTANDING
Your AUDIOGRAM
ANd the Types
of hearing loss
The Comprehensive Guide to Healthy Hearing
©2008-2010 HealthyHearing.com. All Rights Reserved. HH0410
About Hearing
& Hearing Loss
Introduction
We all know someone affected by hearing loss, considering
the recent statistics. Approximately 1 in 10 people have
hearing loss - 1 in 3 if you are over 65 (NIDCD). And experts
say hearing loss is on the rise.
1
Quality of life can be significantly compromised for people with hearing loss and their families.
Hearing loss can refer to severe hearing loss, where loud safety signals may not be heard, or more
commonly, it can manifest as subtle difficulty with word understanding. In these cases, certain
voices or conversations are difficult to hear clearly, especially in noise.
New and better treatments for hearing loss are now available, thanks to advances in healthcare
and medicine. Treating hearing loss has been proven to have very positive effects on quality of life.
Learning about hearing loss – its causes, symptoms and most importantly, what can be done about
it - starts with a basic understanding of our ears and how sound travels through them.
Your Complete Hearing Aids Information Source
Share This Guide!
w w w.HealthyHea ring.com
© 2008-2012 HealthyHearing.com All Rights Reserved
Diagnosis and Evaluation
Your Audiogram
The outcome of the comprehensive hearing evaluation is a
chart of your hearing called an audiogram. Your audiogram
is a record of the softest sounds you heard during your
hearing test (at least half the time, otherwise known as your
thresholds) in each ear.
Loudness is measured in decibels hearing level and is
abbreviated as dB HL. It is represented on the vertical axis
of the audiogram, from approximately 0 dB HL (very soft) to
120 dB HL (very loud).
Frequency or pitch is measured in Hertz and abbreviated as
Hz. It is represented on the horizontal axis of the audiogram,
from 125 Hz (very low pitch) to 8000 Hz (very high pitch).
When testing with earphones (referred to as air conduction
testing), the right ear thresholds are recorded on the
audiogram as O or r and the left ear thresholds are
represented by X or c.
The audiogram to the right has thresholds for the right and
left ears recorded. In this audiogram, the thresholds fall
within the normal hearing range (-10 dB HL to 25 dB HL).
Bone conduction testing determines whether a hearing loss
is conductive, mixed or sensorineural. A headband is placed
over the head with a vibrating piece or oscillator resting
behind the ear. During bone conduction testing, tones
are presented through the oscillator and thresholds are
recorded. Bone conduction thresholds are recorded using >
and < symbols on the audiogram. They may also appear as
] or [.
Your Complete Hearing Aids Information Source
Share This Guide!
w w w.HealthyHea ring.com
© 2008-2012 HealthyHearing.com All Rights Reserved
Diagnosis and Evaluation (cont)
Degree Of Hearing Loss
Hearing and hearing loss can be quantified based on the audiometric thresholds. The American Speech,
Language and Hearing Association (www.asha.org) has established the following standard for diagnosing
the degree of hearing loss:
Mild Hearing Loss
Thresholds in the 26 dB–40 dB range. People with a mild hearing loss have difficulty hearing and
understanding soft sounds and soft speech. Hearing aids are recommended when mild hearing loss
cannot be medically treated. A wide range of styles, including some that are nearly invisible when worn,
is available. New, open ear hearing aid models offer benefits for people with mild and moderate high
frequency hearing loss.
Moderate Hearing Loss
Thresholds in the 41 dB–70 dB range. With a moderate loss, conversations can be difficult to follow,
especially in noisy environments. People with moderate hearing loss often perceive that other people
are mumbling, because their hearing loss prevents them from hearing speech clearly. Even in quiet
environments, people with moderate hearing loss find it hard to have a conversation in a group of people,
or if the person speaking has their back turned or has a soft voice. They may often rely on visual cues or
lipreading to help fill in what they don’t hear, without even realizing it. Hearing aids are recommended for
moderate hearing loss that cannot be medically treated. A wide range of styles is available.
Severe Hearing Loss
Thresholds in the 71 dB–90 dB range. People with
severe hearing loss cannot hear soft or moderate
sounds, birds singing, or conversational speech. They
require the person speaking to them to use a very
loud voice in order to hear speech at all. In addition,
when volume is increased, words or sounds may sound
unclear and distorted.
Profound Hearing Loss
Thresholds greater than 90 dB. Profound hearing loss
is sometimes referred to as “deafness.” People with
profound hearing loss can typically only hear very loud
environmental sounds. In almost all cases of severe
and profound hearing loss, hearing aids or cochlear
implants are recommended.
Your Complete Hearing Aids Information Source
Share This Guide!
w w w.HealthyHea ring.com
© 2008-2012 HealthyHearing.com All Rights Reserved
Diagnosis and Evaluation (cont)
Type Of Hearing Loss
The type of hearing loss – conductive, sensorineural, or mixed – can be determined by
comparing air and bone conduction thresholds. A sensorineural hearing loss exists when both
air and bone conduction thresholds are essentially equal, and are outside the normal hearing
range. A conductive hearing loss exists when bone conduction thresholds are within the
normal range, and air conduction thresholds are not. A mixed loss exists when both air and
bone conduction thresholds are outside the normal range, and air conduction thresholds are
significantly worse than bone conduction thresholds.
I Can Hear, I Just Can’t Understand
This is one of the most common symptoms of hearing loss. But why? In most cases of hearing
loss, there tends to be greater degree of hearing loss for high frequencies than for low
frequencies. This results in persons being able to hear the low-frequency vowel sounds, but
unable to hear the high-frequency consonant sounds. Consonants carry important information
for speech understanding. Here is a visual example. Imagine reading your newspaper and
someone has cut out almost all the consonants from the news stories! You can see the paper,
but you can’t read it. The same happens with hearing loss, you can hear someone talking, but
you can’t understand them clearly.
Recommendations
Following your comprehensive hearing evaluation, recommendations may be made for further
testing, medical referral, and/or treatment, depending on the outcome of your testing. Any
questions or concerns you (or your loved one) have are addressed. In addition, you may be given
more information regarding your specific needs - whether it’s how to protect your hearing if
you’re exposed to noise on a regular basis, or strategies for improved understanding in difficult
listening environments. You’ll be referred to a physician for evaluation and treatment if an
underlying medical condition is suspected, or if hearing aids are recommended, for medical
clearance. In most cases of hearing loss, (including more than 95% of sensorineural hearing
losses), hearing aids or cochlear implants are the treatment of choice.
Your Complete Hearing Aids Information Source
Share This Guide!
w w w.HealthyHea ring.com
© 2008-2012 HealthyHearing.com All Rights Reserved
Hearing Loss and
Quality of Life
A study released by the National Council on Aging (NCOA) in 1999 found that untreated hearing loss was
associated with other quality of life issues. Issues - such as sadness, depression, anxiety, insecurity, and
irritability - that have a negative impact on our overall well-being. Not surprisingly, the study also indicated
that hearing loss affects both the individuals with the loss, as well as their families. These findings were
right in line with those of other smaller studies that linked untreated hearing loss to reduced social activity,
diminished sense of well-being, lowered self-esteem, and an overall negative effect on quality of life.
Better Hearing Is Better Living
The NCOA study also looked at the benefits of treating hearing loss. Fortunately, treating a hearing loss
was found to have a very significant positive impact on quality of life. People who treated their hearing loss
with hearing aids reported improvements in their relationships, feelings about themselves, self-confidence,
independence, and overall quality of life. Their families also reported similar improvements. A summary of
these findings is seen in Table 1.
Improvement
% All Users
% All Family
Relationships at home
56
55
Feelings about myself
50
60
Life Overall
48
62
Mental Health
36
39
Self-confidence
3946
Relationships w/ children, grandchildren
40
52
Willing to participate in grop activities
34
44
Sense of safety
34
37
Ability to play card/board games
31
47
Social life
34
41
Physical health
21
24
Dependence on others
22
31
Relationships at work
26
43
Ability to play sports
7
10
Sex life
8
n/a
Table 1. Percentage of users and family members reporting improvements from using hearing aids.
(Table adapted from Kochkin & Rogin, 2000).
Your Complete Hearing Aids Information Source
Share This Guide!
w w w.HealthyHea ring.com
© 2008-2012 HealthyHearing.com All Rights Reserved
Hearing Loss and
Quality of Life (cont)
The NCOA’s (1999) findings confirmed what professionals who treat hearing
loss have known for decades, and what people who have treated their
hearing loss have learned from personal experience. Simply, that treating a
hearing loss means much more than better hearing. It means a better life
for the people with hearing loss, as well as for their friends and families. This
benchmark study and its conclusions are still relevant today.
More good news: A 2005 Marketrak survey of more than 1500 people who wear hearing aids
found that 90% were satisfied with the benefit of newer models, and over 90% were satisfied
with their service provider (Kochkin, 2005a).
™
Your Complete Hearing Aids Information Source
Share This Guide!
w w w.HealthyHea ring.com
© 2008-2012 HealthyHearing.com All Rights Reserved
Thank you!
Learn More at www.healthyhearing.com
The most comprehensive consumer resource on hearing aids.
References
Burton, P., Smaka C., Powers, T. (2006). Digital Noise Reduction: Yes, There is Research Proving Its
Effectiveness. Hearing Review, 13(3), 82-87.
Kochkin, S. (2002). MarkeTrak VI: 10-Year Customer Satisfaction Trends in the US Hearing Instrument
Market. Hearing Review, 9(10), 14-25, 46.
Kochkin, S. (2005a). MarkeTrak VII: Customer satisfaction with hearing aids in the digital age. Hearing
Journal, 58(9), 29-39.
Kochkin, S. (2005). MarkeTrak VII: Hearing Loss Population Tops 31 Million. Hearing Review, 12(7), 16-29.
Kochkin, S. (2007). MarkeTrak VII: Obstacles to adult non-user adoption of hearing aids. Hearing Journal,
60(4), 24-51.
Kochkin, S. & Rogin, C. (2000). Quantifying the Obvious: The Impact of Hearing Aids on Quality of Life.
Hearing Review, 7(1), 8-34.
Mayo Clinic (2007). Refusing to Face the Facts. How Denial Can Impact Your Health. Mayo Clinic Women’s
Healthsource, 11(4), 7.
National Council on Aging (1999). The Consequences of Untreated Hearing Loss in Older Persons.
Retrieved on October 22, 2008 from http://www.ncoa.org/attachments/UntreatedHearingLossReport%2
Epdf.
National Institutes of Health (2006). Fact Sheet - Cochlear Implants. Retrieved on October 28th, 2008
from http://www.nih.gov/about/researchresultsforthepublic/CochlearImplants.pdf.
NIDCD (2008, August 4). National Institute on Deafness and other Communication Disorders - Quick
Statistics. Retrieved on November 6, 2008 from http://www.nidcd.nih.gov/health/statistics/quick.htm.
Silman S., Silverman C., Emmer M., Gelfand S. (1992). Adult onset auditory deprivation. Journal of the
American Academy Audiology, 3, 390-396.
Your Complete Hearing Aids Information Source
Share This Guide!
w w w.HealthyHea ring.com
© 2008-2012 HealthyHearing.com All Rights Reserved
Copyright © 2008-2012 Healthy Hearing, LLC. www.healthyhearing.com
All rights reserved
Published by Healthy Hearing LLC, Marysville, Michigan
No part of this publication may be reproduced, stored in a retrieval system, or transported in any form or by
any means, electronic, mechanical, photocopying, recording, scanning, or otherwise without prior written
permission of the publisher.
Healthy Hearing LLC authorizes you to view or download a single copy of this book solely for your personal,
noncommercial use if you include the following copyright notice: “Copyright © 2008, Healthy Hearing LLC,
www.healthyhearing.com. All rights reserved” and other copyright and proprietary rights notices that are
contained in the book.
Limit of Liability / Disclaimer of Warranty: While the publisher and authors of this book have used their best
efforts in preparing this book, they make no representations or warranties with respect to the accuracy
of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular
purpose. This book does not provide medical advice and it is not intended to be a substitute for professional
medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health
professional with any questions you may have regarding a medical condition. Never disregard professional
medical advice or delay in seeking it because of something you have read in this book.
Library of Congress Cataloging-in-Publication Data
ISBN 000-0-000-00000-0 (electronic only)
Developed in the United States of America
10 9 8 7 6 5 4 3 2 1
Your Complete Hearing Aids Information Source
Share This Guide!
w w w.HealthyHea ring.com
© 2008-2012 HealthyHearing.com All Rights Reserved