Interpreting  Audiological Results

Components of an Audiometric Report

A comprehensive audiometric evaluation typically includes the following measures: otoscopy (i.e. visual examination of the outer ear), tympanometry (i.e. a measurement of eardrum mobility and middle ear function), puretone testing (i.e. testing to find the softest sounds that can be heard for a range of pitches), and speech testing such as a speech reception threshold (SRT; i.e. a verbal measure of the softest words that can be identified) and discrimination testing (i.e. assessment of the accuracy in listening to speech). Sometimes, these measures are not able to be obtained (e.g. the child is too young to participate or there are ear anomalies which prevent measurement). Additional measures may also be obtained (e.g. acoustic reflexes, speech discrimination in noise, aided testing, etc.). It may be necessary to adapt “standard” procedures to ensure accurate and comprehensive testing; the audiogram should include a “key” to indicate procedures utilized. The key may resemble the following: 

The key to decipher results of puretone testing may resemble the following: 

The report that follows hearing testing should include several sections including “participant” information, case history, objective data, and interpretation of results. The participant information should include information such as the child/student’s name, his date of birth, the date of testing, name of the audiologist providing testing (please note that pediatrics/children under the age of 18 must be seen by an audiologist per FDA law), etc. Case history encompasses information reported by the student and/or his family; this may include information regarding concerns related to hearing, achievement of developmental milestones, results from questionnaire(s), etc. Objective data should be indicated in “raw” or interpreted format along with explanation of results. While some clinics may provide a printout of raw results on the day of testing, it is critical that analysis by an audiologist, accompany the audiogram. The finalized report may need to be requested to ensure the interpretation of results be provided for the Eligibility/IEP Team consideration. 

Vocabulary often found in ear-related reports: 

Common Audiological Procedures

• • Air conduction (AC) testing: refers to listening though the entire auditory system...in testing, usually via headphones or insert earphones. 

  • Bone conduction (BC) testing: refers to the child listening to sounds through the bone oscillator (i.e. the headband) placed behind the ear. This stimulates the inner ear more directly and shows potential for better hearing in children with conductive hearing loss. 

  • Conditioned play audiometry (CPA): response pattern used for testing young children. The child listens to tones and completes an action (e.g. places a block in the bucket when a sound is heard). It is an easier process for a child than raising a hand. 

  • Impedance testing (also see tympanometry): refers to assessment of middle ear function

  • Masking: sound presented to the non-test ear to ensure results represent the desired ear to be tested (i.e. it keeps the "good" ear busy)

  • Otoacoustic emissions (OAEs): a method of assessing inner hair cell function. Does  not require a behavioral response from the child however, it does require the child to sit quietly during the recording. In the presence of appropriate outer & middle ear findings, OAEs may be indicative of hearing loss.

  • Otoscopy: visual inspection of the ear and ear canal. 

  • Puretones: testing of specific tones as displayed on the audiogram. Gives pitch-specific knowledge about a child's hearing abilities. In a screening setting, tones of 500, 1000, 2000, and 4000 Hz are presented to each ear.

  • Speech discrimination testing: refers to the accuracy of a child's ability to repeat back words at a particular listening level. Usually completed in optimal listening conditions (i.e. a controlled soundbooth without noise)

  • Speech recognition testing (SRT): a measure of the softest sound a child can identify familiar spondaic (2-syllable) words by pointing or verbally repeating the presented words.

  • Soundfield: Refers to responses obtained in a soundbooth without the use of ear-specific methods (e.g. headphones)

  • Tympanometry (abbreviated "tymps"): assessment of middle ear function. Denoted by: 

    • • Normal A: a typical/appropriate response pattern. 

      • Type As : denotes slight restriction of eardrum movement. 

      • Flat Type B: significant restriction of the eardrum. May be indicative of middle ear fluid or excessive wax. 

      • Type C: obtained when the eardrum is significantly retracted. May be seen at the start or end of congestion.

Common Phrases in Reports Involving the Ear and Hearing

• • Auditory neuropathy/ auditory dysynchrony: a type of sensorineural hearing loss that is associated with poorer ability to understand speech than would be predicted from the puretone responses.

  • Atresia: absence of the ear canal. Often accompanied by microtia.

  • Bilateral: involving both ears

  • Cerumen: ear wax.

  • Cholesteatoma: abnormal growth in the middle ear, often following ongoing middle ear congestion, which causes conductive hearing loss. Can be accompanied by drainage. Often medically treatable but may reoccur.

  • Cochlea: snail-shaped portion of the inner ear that houses hair cells. 

  • Conductive hearing loss: hearing loss from the outer or middle portions of the ear. Often treated through medical management. May be temporary (e.g. from ear infection) or permanent. 

  • Connexin 26-Related Sensorineural Hearing Loss –a nonsyndromic hearing loss that usually is present from birth. 

  • Hair cells: structures within the inner ear which respond to sound and stimulate the auditory nerve.

  • Idiopathic – refers to an unknown cause

  • Eustachian tube: body structure that connects the middle ear to the back of the throat. Dysfunction can lead to middle ear fluid and/or ear infection.

  • Englarged Vestibular Aqueduct (EVA) / Large Vestibular Aqueduct Syndrome (LVAS) – a type of abnormal development of the inner ear which results in progressive sensorineural hearing loss. Hearing loss often worsens with head impact. 

  • Etiology: refers to the source or cause

  • Fistula: abnormal hole. 

  • Middle Ear Fluid/Effusion – presence of fluid within the middle ear which may result in conductive hearing loss. Often medically managed.  

  • Microtia – small ear (pinna). Often occurs with atresia 

  • Myringotomy/Pressure Equalization (PE) Tubes – small tubes surgically placed by an ear, nose, and throat specialist to reduce ear infections. There are different sizes and shapes of the tubes that will influence the duration they remain in the eardrum; some tubes will fall out after a couple of months, while others must be surgically removed. 

  • Noise Induced Hearing Loss –hearing loss that occurs from excessive noise 

  • Otosclerosis –condition involving abnormal bone growth around the connection of the stapes (a middle ear bone) to the cochlea (the hearing part of the inner ear)

  • Ototoxicity –refers to damage of the auditory system secondary to medications 

  • Perforated/Ruptured Eardrum –a hole in the eardrum. There are a variety of causes, including untreated ear infection, acoustic trauma (extreme excessive noise), and/or trauma to the ear. Some perforations will independently heal while others will be surgically repaired by an ear, nose, and throat physician

  • Sensorineural hearing loss: hearing loss that occurs within the inner ear and/or auditory nerve. May be stable or progressive over time.

  • Stenosis –refers to a narrow ear canal. 

*Please note the following is not intended to serve as a comprehensive resource of medical terminology; it is provided as a quick illustration of the diversity of terms that may be present within an audiological report.