I was wondering about the following related to doing a hearing test and seeing the results in an audiogram.
Q1: my audiogram has 9 frequency points (125/250/500/1000/2000/3000/4000/6000/8000hz). Looking at the diagram it seems 750hz and 1500hz were not measured. Is there anything to gain from having a more granular audiogram? I would expect the answer to be yes as the audiogram is the primary input for programming of the hearing aid.
Q2: when doing multiple hearing tests in a row (back to back or multiple days in a row, etc.) should the results always be the same or is deviation to be expected?
Q3: are there programs/apps available to consumers to do your own hearing test? How good are they and can they be compared to the results from my professional hearing test (done at the university hospital)?
In general, I’d say there’s some benefit, but unlikely in yours in that your audiogram has the same values on either side of those frequencies.
Deviation can be expected.
There are a lot of online hearing tests. The challenge is how to calibrate the loudness. IF you have the professional programming software and a programming device (See DIY part of the forum), one can run an in situ audiogram through the hearing aids. These results should be similar to what a professional one would be, but are not directly comparable.
About answer 2. If deviation is normal between tests how reliable is my one-time test? Should I ask my audiologist to do multiple hearing tests and take the average as input for programming my hearing aid?
Reason for asking Q2 & Q3 is because my hearing aid specialist also did a hearing test (which was definitely more simple and done under circumstances which were a lot less optimal when compared to the hearing test done at the hospital) and was surprised to find a frequency response which was quite different in the 2000hz area.
So I was wondering if there was a way for me to verify my audiogram myself… (I do have a calibrated microphone which is used for Digital Room Correction (which I guess is a similar principle as Real Ear Measurements), maybe I can use that to calibrate the loudness?)
Tests are pretty reliable and averaging results is not typically done. How much are you considering “quite different?” 5dB differences are pretty much to be expected. 10dB differences are not uncommon and 15dB differences are possible. Even a 15dB difference is only going to result in 5dB difference in hearing aid gain (assuming sensorineural hearing loss). How are you hearing ? I’d focus on how you’re hearing and let your audiologist know. Hearing aids definitely take some time to adjust to. I suspect having essentially normal hearing one ear and a notable loss in the other would take some time to get used to. Do they know why your loss is so uneven?
As the resolution of the audiogram is 5dB I understand deviation of 5dB is to be expected. But I am not sure how to explain 15dB deviation as not uncommon given the fact that 3dB is double the energy.
I am sorry, I don’t understand this question.
I am experiencing single sided deafness in my right ear while my left ear is just fine. My hearing loss started many years ago but progressed slowly. 10yrs ago I visited the ENT doctor but they were unable to explain my hearing loss. At that time they concluded it must be caused by loud noise damage. Now 10 yrs later I had to go back to my ENT as my hearing loss is starting to have a real impact on my life. The hearing test showed a huge loss (10 - 20dB loss became 50dB loss). This proves my hearing problem is not caused by loud noise but it is unclear what the cause is. I had an MRI 10yrs ago and just recently again and there is no tumor. My ENT doctor tells me I am in this exceptionally small group of people experiencing SSD with this level of hearing loss for which they cannot find a cause.
I was assuming you were wearing a hearing aid on your right ear, but that appears not to be the case? That’s what I meant by how is your hearing? I meant to focus on how well the hearing aid was working for you but if you don’t have one, that was a stupid question on my part.
Does the ENT think a hearing aid would be beneficial? If not, why not? Also, if not, perhaps a cochlear implant.
Regarding dB of hearing loss. Although 3dB implies a doubling of energy, it is not a doubling of perceived loudness.
Basically I’d say work with your ENT. If you’re not getting questions answered satisfactorily, consider getting a second opinion.
Yes, I am wearing a hearing aid since a couple of days now. For now my initial impression is it helps me in certain scenario’s to better hear speech but obviously I am still in the learning and getting used to phase.
I am trying to get familiar with topics related to my hearing loss and hearing aid as much as possible.
I want to optimize the input for my hearing aid specialist. For that reason the questions on audiograms.
I was wondering if there is room for improvement from the audiogram perspective. Especially because the hearing aid specialist did a simple hearing test and was surprised to find results which differ from the hearing test results done at the ENT.
I am not an expert by any means. I just read this forum often and try to pay attention to those with experience.
Your audiogram shows a single sided hearing loss that now appears to getting into the good ear. My bet is it is age related.
Your left ear has hearing loss at the 4000 hertz and up, that is showing up in your ability to hear, especially in noise. Your hearing has been carried by your good ear I suspect.
You have come to a great place to learn about your hearing and hearing aids.
I don’t understand why people don’t ask their audiologist about any questions they may have. At least then people with knowledge, on this forum, could be more helpful with their response. Just saying.
I am not sure where the confusion is coming from. I am under treatment of a ENT. The ENT wrote a prescription for me to bring to a hearing aid specialist. The hearing aid specialist is supplying the hearing aid. In my country (the Netherlands) the ENT is not supplying hearing aids.
As part of the initial configuration of the selected hearing aid the hearing aid specialist also did a hearing test (but like said: much more simple as the one done at the ENT). The resulting audiogram was different from my audiogram from the ENT.
This difference in audiograms made me wonder. How precise is a hearing test? Are the results expected to be repeatable? Can I maybe do a hearing test myself to verify results? All these questions originate from the general idea: how can I deliver better input so the hearing aid specialist can better configure my hearing aid.
I have extra appointments scheduled with the hearing aid specialist to discuss my findings and do additional tweaking of the hearing aid configuration.
I also have an extra (at a later moment) appointment with the ENT to extra verify if the hearing aid delivered by the hearing aid specialist is working as the ENT believes it should work.
My hearing problem is quite a mystery to me and my ENT. It seems I have to accept the fact that I have unexplainable SSD which seems to progress a lot (in the last 10 years). Not knowing what is the cause gives me a lot of frustration. I was tested twice (10y interval) by MRI for vestibular schwannoma.
My left ear is fine. According to the ENT the audiogram is according to expection for my age (50). I perceive my left ear as fine.
In my twenties I was already aware my right ear is not as good as my left ear. The loss of hearing in my right ear slowly progressed over the years but it seems its degradation sped up a lot in the last 10 years. Due to the gradual loss of my hearing in my right ear I have become quite accustomed to my asymmetrical hearing.
So again: I hoping to learn more about my hearing problem and related topics by reading this forum and asking questions so I can bring that information back to the hearing aid specialist and ENT and hopefully get better results compared to not doing this research.
I would be inclined to get another no-obligation hearing test elsewhere for further corroboration. Those flat lines from the ENT don’t seem reasonable (to me).
You can do your own unofficial, threshold test online. It will play tones and you keep turning down the volume until you can’t hear it and then bump it up again to get the threshold. All things remaining equal, that will give you another data point. Just not official.
I don’t know what your actually trying to achieve, I mean you do the audiogram and then you get your HAs programmed to suit, why do you want to keep checking to what loss you have an any given day/week,time, are you going change the settings in your HAs to suit? It’s common to get a new test every 2 or so years, and then have them adjusted if need be, everyone’s hearing fluctuates all the time, so I’d just leave it up to your audiologist, why are you still seeing this ENT? are you just going to get him/her to check your audiologist’s settings! Your over thinking everything here, just let your audiologist clinic sort your hearing out, you seem to be “doubtful” about your hearing tests,even to the point of wanting to “verify” yourself the results,seems all a bit odd to me.
Maybe I am mixing up the functions of ENT & audiologist? (I did some Googling and I guess I did mix up the terms.)
I was sent to the hospital for further investigation by my general physician. This hospital has an audiology center where I did the hearing tests. Then I went to the ENT which ordered a MRI to see if a tumor could explain SSD. In a final session with the ENT he explained I have unexplainable SSD. I guess the part with the ENT is now finished and my treatment is now handled by the hospital’s audiology center. The doctor in the audiology center examined my hearing problem further by asking many questions. After that came a recommendation to improve my hearing by getting a hearing aid. The audiologist wrote me a prescription for me to bring to a hearing aid specialist. The hearing aid specialist used the prescription to propose a specific hearing aid model (Phonak Audeo M50-R). During initial fitting the hearing aid specialist did another hearing test. The results surprised her and she asked me which audiogram to use for the programming of the hearing aid. I told her I prefer to use the hospital audiogram as input as I have higher confidence in that test.
This event with the different hearing test results made me think about hearing tests and their reliability and repeatability. For that reason I wrote Q1 & Q2 in my initial post.
This is part of the treatment proposed by the hospital audiologist. When the hearing aid specialist is finished I am going back to the hospital / audiology center and as I understand they want to do additional hearing tests to verify if the hearing aid is configured as they believe it should be given my hearing loss. I am just following their recommendations…
I only saw the other surprising results quickly on the computer screen of the hearing aid specialist. No time to analyse. At that time I dismissed the results thinking the environment was suboptimal.
For reference here are my 2 audiograms from 2012 and 2022.
Thanks for the audiograms.
They are very helpful.
More members will chime in on this now.
Your right ear word understanding has really declined from the first audiogram.
Just saying…you need to get an aid on that ear and wear it it all the time. You just might get some of that word understanding back.
Good luck.
To answer your original question, regular possible sources of variability in the audiogram assuming no other patient medical issues are: machine calibration, depth/seal/positioning of headphones, testing procedures, testee signal detection criteria.
Machines are calibrated annually against an international standard and clinicians maintain/clean and run their own less intensive checks regularly. Clinicians should be managing appropriate placement of the headphones and following standardized testing procedure. We cannot really control patient signal detection criteria and it does vary from test to test or even within tests, but if all this other stuff is optimized that should be limited to about a 5 dB test-retest variance. You can see, however, where more variability than desired can creep in. Accuracy can indeed be increased by averaging multiple tests if hearing is stable and presuming there isn’t a calibration issue.
Having a big difference just at 2 kHz is odd. Headphone placement issues typically show up at the top and bottom, not in the middle like that.
Per your question about 750 and 1500, testing these is non-standard if the audiogram is flat, though some clinicians do it anyway. A big dip in those interoctaves would be very unusual, and a small dip of say 5 dB. . . is that more likely to represent a true difference in the damage to the cochlea at just that spot (rather than more evenly distributed damage across the cochlea, recalling also that high frequencies are more vulnerable and the layout is logarithmic), or testing variability.
