There’s more than one reason why hearing loss occurs. From ageing and genetics to certain medicines and diseases, hearing loss can go unnoticed until it becomes severe and interferes with daily life. Audiometry is a non-invasive hearing assessment used to measure an individual’s hearing ability.

It is useful for diagnosing hearing loss, measuring its severity, and determining the appropriate treatment or management approach. Performed by audiologists, the test is particularly important for people experiencing hearing difficulties, tinnitus, or balance problems.

In this blog, we will explore the audiometry test in detail, including its purpose, procedure, and benefits, so you can better understand what to expect from the process.

What is the Audiometry Test?

An audiometry test is a safe, painless, and non-invasive procedure that measures an individual’s ability to perceive sound, assessing how well you hear different pitches and frequencies. The process is carried out using an audiometer and typically lasts for around 20 - 40 minutes. 

During the assessment, sounds will be delivered through headphones or transducers, and the individual’s responses are recorded. Depending on the type of test, the assessment examines the softest sounds a person can hear, their ability to understand speech, or how different parts of the auditory system are functioning. 

The results are commonly represented on an audiogram, which provides a visual record of hearing thresholds across different frequencies. This information can help an audiologist or ENT specialist determine whether hearing loss is present, and when appropriate, identify its type and severity.

What is the Importance of the Audiometry Test?

The audiometry test provides valuable information about hearing sensitivity in each ear and helps identify changes that may not be noticeable in everyday life. The test is important because it can:

• Provide a baseline of a person’s hearing ability for future comparison.
• Identify subtle changes in hearing that may otherwise go unnoticed.
• Assess hearing in each ear individually and highlight differences between them.
• Provide objective information that helps healthcare professionals understand a person's overall hearing profile.
• Help determine whether a person may benefit from further hearing evaluation or monitoring.

A hearing assessment may also be recommended when symptoms such as difficulty following conversations, frequently asking others to repeat themselves, or struggling to hear in noisy environments are present.

What are the Uses and Benefits of the Audiometry Test?

Audiometry is used in several clinical situations, from evaluating suspected hearing loss to monitoring changes in hearing over time. The specific test selected depends on the person’s age, symptoms, and clinical requirements.

Some of its key uses and benefits include:

• Detecting Hearing Loss

Audiometry can identify whether a person has reduced hearing sensitivity and determine which frequencies are affected. This can be useful when hearing loss is gradual and difficult to notice in everyday situations.

• Assessing the Degree and Pattern of Hearing Loss

The test can show whether hearing sensitivity is within the expected range or reduced at certain frequencies. The findings can help medical professionals understand the extent of the hearing difficulty.

• Identifying the Type of Hearing Loss

When combined with appropriate tests such as air and bone conduction assessment, audiometry can help identify patterns consistent with conductive, sensorineural or mixed hearing loss.

• Monitoring Hearing Over Time

Repeat hearing assessments can help track changes in hearing, particularly when a person has an existing hearing condition or has ongoing exposure to loud sounds.

• Supporting Further Evaluation and Management

The findings can help an audiologist or ENT specialist decide whether additional investigations or hearing rehabilitation may be needed.

What Are the Types of Audiometry Tests?

Two commonly used types of audiometry are:

1. Pure Tone Audiometry

A pure tone audiometry test, often considered one of the main components of a comprehensive hearing assessment, measures the softest tones a person can hear at different frequencies. Sounds are presented through headphones or other appropriate transducers, and the person responds when a tone is heard.

Air conduction testing assesses hearing through the normal pathway of the outer and middle ear, while bone conduction testing uses a bone vibrator to transmit vibrations through the skull to the inner ear. Comparing these results can help identify the type of hearing loss. 

2. Speech Audiometry Test

A speech audiometry test assesses how well a person detects and understands spoken words. Depending on the assessment, the person will be asked to listen to speech at different levels and repeat the words they hear. Speech testing provides information about functional hearing and speech understanding, complementing the information obtained from pure tone testing. 

How Does the Audiometry Test Work?

The exact procedure varies according to the type of hearing assessment being performed, but most behavioural audiometry tests involve listening carefully and responding to sounds. A typical pure tone assessment involves the following steps:

• Initial assessment: The audiologist asks about hearing concerns, medical history, exposure to loud sounds and other relevant factors.
• Positioning: You will be seated in a quiet or sound-treated room and given headphones or other appropriate earphones.
• Sound presentation: The audiometer presents tones at different frequencies and intensity levels, usually testing one ear at a time.
• Responding to sounds: You will be asked to press a button, raise your hand or provide another signal whenever you hear a sound, even if it is very faint.
• Bone conduction testing: When required, a bone vibrator will be placed behind the ear or on the forehead to assess bone conduction hearing.
• Speech testing: If speech audiometry is performed, you will be asked to listen to and repeat words or respond to spoken sounds.
• Recording results: Your responses are recorded and used to determine hearing thresholds and prepare the audiometry test report.

Why and When is the Audiometry Test Performed?

An audiometry test will be performed whenever there is a concern about hearing or when a medical professional needs a detailed assessment of auditory function. It is often recommended for:

• Difficulty hearing conversations or understanding speech
• Frequently asking people to repeat themselves
• Difficulty hearing in noisy environments
• Suspected hearing loss in children or adults
• Monitoring an existing hearing condition
• Evaluation following certain ear conditions or injuries
• Assessment when there is a history of prolonged or significant noise exposure
• Hearing evaluation as part of the assessment for hearing-related symptoms

The test may also be used as part of a broader evaluation when an ENT specialist or audiologist needs more information about a person’s hearing. Audiometry can detect hearing loss, but the test results need to be interpreted alongside the individual’s symptoms and clinical history. 

How to Prepare for the Audiometry Test?

In most cases, no special preparation is required for a standard audiometry test. However, providing accurate information to the audiologist can help ensure that the assessment is interpreted in the right clinical context.

Here are some things to do before the test:

• Inform the healthcare professional about any hearing difficulties or changes you have noticed.
• Mention any history of ear infections, ear problems, injuries or previous hearing assessments.
• Tell the audiologist about regular exposure to loud sounds, if relevant.
• Follow any specific instructions provided by the hospital or audiologist. 

It is also important to follow the instructions given during the test carefully. Staying attentive throughout the process is important, as the procedure depends on your responsiveness to the sounds you hear. 

How Are Audiometry Test Results Interpreted?

The results of a hearing assessment are commonly presented as an audiogram, which plots hearing thresholds at different frequencies. The audiologist reviews the pattern of results for each ear and considers findings from the relevant tests.

A typical audiometry test report provides information about:

• Frequency: The pitch of the sound being tested, measured in Hertz (Hz).
• Intensity: The loudness level at which a sound is presented, measured in decibels (dB).
• Hearing thresholds: The softest levels at which sounds can be detected at different frequencies.
• Air conduction results: Hearing measured through the usual outer and middle ear pathway.
• Bone conduction results: Hearing assessed through vibrations transmitted to the inner ear through the skull.
• Speech test findings: Information about the ability to detect and understand spoken words when speech audiometry is performed.

The pattern of air and bone conduction thresholds can help a healthcare professional assess whether findings are consistent with conductive, sensorineural or mixed hearing loss. Speech testing can provide additional information about how effectively a person understands speech.

An audiogram should not be interpreted based on a single number alone. The overall pattern, the results from both ears and the findings of other assessments all matter.

What is the Normal Range for the Audiometry Test?

A commonly used clinical reference is that hearing thresholds from approximately 0 to 25 dB HL are considered within the normal range for adults. However, the interpretation of audiometry results may vary depending on factors such as the person's age, the type of hearing test performed, and the overall clinical context.

The results should be interpreted by a qualified audiologist or healthcare professional, as hearing ability is assessed based on the overall pattern of results across different frequencies and both ears rather than a single threshold or number in isolation.

What Factors Can Affect Audiometry Test Results?

Audiometry is designed to provide reliable information about hearing sensitivity, but several factors can influence the results or their interpretation. These include:

• Background noise: Unwanted sound in the testing environment can interfere with the ability to detect faint tones.
• Attention and concentration: Audiometry often requires active participation, so difficulty concentrating may affect responses.
• Understanding of instructions: The person being tested needs to understand when and how to respond to sounds.
• Temporary ear conditions: Earwax blockage, fluid in the middle ear or an active ear condition can affect hearing measurements.
• Fatigue: Longer or detailed assessments may be more difficult if the person becomes tired or loses concentration.
• Age and developmental level: The approach used for testing may need to be adapted for young children or individuals who cannot reliably respond to conventional behavioural tests.
• Recent noise exposure: Exposure to loud sounds before testing may temporarily affect hearing sensitivity in some individuals.

For these reasons, audiometry results are best interpreted by an audiologist or ENT specialist in the context of the complete clinical picture. 

What Do Abnormal Results Mean?

An abnormal result generally indicates that hearing sensitivity is reduced in one or both ears, or that the hearing pattern requires further evaluation. The significance depends on the degree of hearing loss, the frequencies affected and the result of air and bone conduction testing.

Broadly, hearing loss is classified as:

• Conductive hearing loss: Occurs when sound is not efficiently conducted through the outer or middle ear.
• Sensorineural hearing loss: Involves the inner ear or the nerve pathways responsible for transmitting sound information to the brain.
• Mixed hearing loss: Has both conductive and sensorineural components.

An abnormal audiometry test does not, by itself, establish the exact cause of hearing loss. Further evaluation may be required to understand the underlying condition and determine appropriate management.

What Are the Risks Associated with the Audiometry Test?

Audiometry is generally considered a safe and risk-free behavioural assessment. It does not involve needles, radiation, or surgical procedures. 

The test itself should not cause pain or discomfort. The main requirement is that the person being tested listens carefully and responds to the sounds or instructions provided. If a person experiences discomfort during any part of the assessment, they should inform the audiologist or healthcare professional conducting the test.

How Much Does an Audiometry Test Cost?

The audiometry test price can vary depending on several factors, including the type of hearing assessment performed, the healthcare facility, the number of tests included and the location.

A basic pure tone assessment may have a different cost from a comprehensive evaluation involving speech audiometry or additional tests such as tympanometry. Therefore, it is advisable to check the current test charges with the hospital or diagnostic facility before scheduling the appointment.

What Happens After the Audiometry Test?

Once the assessment is complete, the audiologist reviews the findings and prepares the audiometry test report. The audiologist may then discuss the results with you and advise you to consult an ENT specialist if further evaluation is required.

Depending on the findings, the next step may involve:

• Monitoring hearing through follow-up assessments.
• Further evaluation to identify the cause of hearing loss.
• Management of an underlying ear condition, when identified.
• Hearing rehabilitation or hearing devices, when appropriate.
• Additional audiological tests for a more complete assessment.

The appropriate next step depends on the individual's results and clinical needs rather than on the audiometry report alone.

Get a Comprehensive Hearing Evaluation at Amrita Hospital, Faridabad

Hearing difficulties can affect communication and everyday life, but identifying the problem is the first step towards appropriate care. An audiometry test provides valuable information about hearing sensitivity and can help healthcare professionals understand whether further evaluation or management is needed. 

At Amrita Hospital, Faridabad, the ENT department is equipped with audiometers and provides a range of audiology services, including pure tone audiometry and special tests, tympanometry, BERA, ASSR, OAE and behavioural observation audiometry. The department also provides ENT evaluation and management for a range of ear-related conditions. 

If you have concerns about your hearing or have been advised to undergo hearing tests, consult the ENT and audiology team at Amrita Hospital, Faridabad, for an appropriate evaluation.

Frequently Asked Questions

1. What is audiometric testing used for?

Audiometric testing is used to assess how well a person can hear sounds of different frequencies and intensities. It can help detect hearing loss, determine its degree and pattern, and provide information that supports further evaluation and management.

2. What are the 4 types of hearing loss?

The four commonly described categories are conductive, sensorineural, mixed, and auditory neuropathy spectrum disorder (ANSD). Conductive hearing loss involves problems transmitting sound through the outer or middle ear, while sensorineural hearing loss involves the inner ear or auditory nerve pathways. Mixed hearing loss has both conductive and sensorineural components, whereas ANSD is associated with disrupted transmission of sound signals from the inner ear to the brain despite the cochlea sometimes functioning relatively normally.

3. What are the two types of audiometry?

The two broad approaches commonly discussed are pure tone audiometry and speech audiometry. Pure tone testing assesses hearing sensitivity to tones at different frequencies, while speech audiometry evaluates the ability to detect and understand spoken words. Both can provide complementary information during a hearing assessment.

4. What happens after audiometry?

After audiometry, the audiologist reviews the findings and prepares the audiometry test report. Depending on the results, you may be advised to undergo additional testing, consult an ENT specialist, monitor your hearing over time or explore appropriate hearing rehabilitation options.

5. Can hearing loss be detected through an audiometry test?

Yes. Audiometry can detect hearing loss by measuring how softly a person can hear sounds at different frequencies. The result can also help show the degree and pattern of hearing loss, while air and bone conduction findings may help identify whether the pattern is conductive, sensorineural, or mixed.