Could someone help me understand what is the line above the measurement in the left ear? Is it Bone conduction measurement? If so, why was it measured in the left ear but not the right one? Does it make any difference when I fit my hearing aids by myself using Target?
Well, you’ll no doubt hear from experts here, but your left ear’s hearing is far below the right one’s, so perhaps if that line above is a bone conduction test, maybe you didn’t need it on the right ear?
I sure hope you’re pointed in the right direction for your own self-fitting in Target. Another example of how you TAKE charge and get the job done.
As I mentioned in the other thread; the reading for your left ear is likely to be bogus. There’s no AC result for the left ear on there at all.
Even at 105dB presentation your WRS is only 24%, which means that you really don’t get decent clarity in that side. It’s likely that your opposite cochlea is hearing the sound.
If you can, try to get another test from someone who knows how to do masking properly so you can identify whether there’s any functioning hearing in your left ear at all.
If there’s no usable hearing in that ear, it doesn’t matter if it’s aided or not, unless you’re putting a CROS system in.
They’ve drawn the Left with BC symbols - where’s the X symbols for the true left response - actually looking at the key they’ve used the dellta triangle for masked AC - which is weird. Normall we show these as an X with the bottom quadrant filled in. The key is also wrong for the right as the NR values uses the same symbol as the actual value when the tester uses the down right arrow on the chart… This is why nobody should be doing hand written Audiograms in the real world.
That said, I’ll still have a £1 on the fact that they stuffed up the masking and there’s either none or practically no hearing in the LEFT. Partially because anything more than a 40dB air-bone gap can’t exist in one isolated ear, partly because the Left BC (I think) - is analgous to the right response.
Or it’s entirely accurate and the 24% score at 105 dB is just a resolution issue on that side.
Either way that ear doesn’t accept sounds and certainly offer much in terms of understanding speech - even at 105dB. Which rules it out for being aidable as you’d be stuffing 80dB+ more in the bad ear and really killing the resolution to the good side.
The line above the left ear thresholds is likely meant to be bone conduction. The triangles, however, are suspicious because masked left AC thresholds are supposed to be squares (masked right AC thresholds are triangles). That being said, the code/legend on the right side of the page seems to defend it, but it is indeed awkward from a clinical communication standpoint…"7"s for masked bone conduction?
As far as only measuring bone conduction on the left, I have heard of testers using a shortcut where they test the poorer hearing ear and hope the unmasked threshold matches the right AC threshold so they can justify not measuring the better hearing ear.
Anyway, the biggest fitting consideration regarding the left ear is the type of hearing loss i.e. conductive versus sensorineural versus mixed. The more conductive a hearing loss is, the less cochlear recruitment you will be sensitive to, and the less compression you will need. However, your word recognition score on the left is pretty poor, which is not common with a conductive hearing loss. Without having your hearing retested, I bet your left ear is sensorineural. If you don’t input bone conduction thresholds, I think Target assumes the hearing loss is sensorineural.
EDIT after reading @Um_bongo 's reply, if masking is suspect at all it is not unlikely that even the left AC thresholds are suspect.
I’m not sure if I can but I can definitely try!
Loudness recruitment is when a cochlear hearing loss distorts growth of perceived loudness. This is probably best explained with your right ear audiogram, let’s just look at 2000 Hz where your threshold is 65 dBHL. If 95 dBHL is played at that frequency, you will hear it as a level of loudness similar to how someone with normal hearing would. However, if 45 dBHL is played you would not hear it at all. Essentially there is quicker growth in loudness compared with someone with normal hearing. Because of this, you would not want linear gain (equal gain at all input levels) here because if something enters the hearing aid at an already loud level the hearing aid will amplify way past comfort and certainly into dangerous levels.
Regarding the notes on the back, if the left bone conduction thresholds are true, then the left ear has a mixed hearing loss. A mixed hearing loss is essentially a conductive hearing loss on top of a sensorineural hearing loss. If you look at the recommendations, the examiner only recommends a hearing aid to the right ear, which I tend to agree with because you don’t have much residual on the left side. However, the WRS of 24% in the left ear is better than I’d expect given AC thresholds, but not unexpected given the better BC thresholds. Worst case scenario, aiding the left ear would allow for sound awareness and localization.
Yes, the examiner thought that my left ear was useless and he advised against having it aided which I didn’t like. I still hear some “sounds” on the left side when I put on my hearing aid. Yes, it doesn’t help enough and I have big trouble understanding people in different contexts but I’d like to keep it active, hoping one day I will be able to have it implanted.
Please get a repeat test from a certified, doctoral Audiologist who understands clinical testing procedures and how to represent them correctly on paper.