Audiometry

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Audiometry procedure

An audiometry evaluation is a painless, noninvasive hearing test that measures a person’s


ability to hear different sounds, pitches, or frequencies. Patients who have a tumor in or around
the ear may undergo audiometry testing to determine whether hearing loss has occurred or to
monitor their hearing before and after surgery. It is also used to evaluate whether hearing aids
or surgery may improve one’s hearing. Audiometry is a procedure to measure hearing
sensitivity of a ear.

Audiogram

The graphical representation of audiometry results are called Audiogram. An audiogram is a


graph that shows the audible threshold for standardized frequencies as measured by an
audiometer. The Y axis represents intensity measured in decibels and the X axis represents
frequency measured in Hertz. Most audiograms cover a limited range of frequencies 100 Hz to
8000 Hz (8 kHz) because this range includes the fundamental frequency of sounds in speech.
The threshold of hearing is plotted relative to a standardised curve that represents 'normal'
hearing, in dB(HL). Pure tone audiometry charts the hearing level of different tone frequencies
in both ears. On an audiogram chart, red O's indicate the right ear's results and blue X's the left
ear's results.

Pitch (frequency)

The TONE of sound is measured in cycles per second (cps) or Hertz:

 Low bass tones range around 50 - 60 Hz


 Shrill, high-pitched tones range around 10,000 Hz or higher

The normal range of human hearing is about 20 Hz - 20,000 Hz. Some animals can hear up to
50,000 Hz. Human speech is usually 500 - 3,000 Hz.

Normal hearing range is 250-8,000 Hz at 25 dB or lower.

Intensity

The INTENSITY of sound is measured in decibels (dB):

 A whisper is about 20 dB
 Loud music (some concerts) is around 80 - 120 dB
 A jet engine is about 140 - 180 dB

Sounds greater than 85 dB can cause hearing loss after a few hours. Louder sounds can cause
immediate pain, and hearing loss can develop in a very short time.
The Intensity range of a human ear is -10dB to 120 dB.

Audiometry

A pure tone audiometry test measures the softest, or least audible, sound that a person can
hear. During the test, you will wear earphones and hear a range of sounds directed to one ear
at a time. The loudness of sound is measured in decibels (dB). In audiometry test, we measure
the least intensity level at various frequencies.

Hearing loss is often described as follows:

 Normal = less than 25 db HL


 Mild = 25-40 db HL
 Moderate = 41-65 dB HL
 Severe = 66-90 db HL
 Profound = more than 90 db HL

The test is conducted in the following way. The first steps are to see whether you need an
audiogram. The specific procedures may vary, but they generally involve blocking one ear at a
time and checking your ability to hear whispers, spoken words, or the sound of a ticking watch.

A tuning fork may be used. The tuning fork is tapped and held in the air on each side of the
head to test the ability to hear by air conduction. It is tapped and placed against the mastoid
bone behind each ear to test bone conduction.

Audiometry provides a more precise measurement of hearing. To test air conduction, you wear
earphones attached to the audiometer. Pure tones of controlled intensity are delivered to one
ear at a time. You are asked to raise a hand, press a button, or otherwise indicate when you
hear a sound.

The minimum intensity (volume) required to hear each tone is graphed. An attachment called a
bone oscillator is placed against the bone behind each ear (mastoid bone) to test bone
conduction.

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