How to Read an Audiogram: A Simple Patient Guide

Short answer

An audiogram (An audiogram is a graph showing the softest sounds a person detects at different frequencies.) is a graph showing the quietest sounds you can hear at different pitches.

The simplest way to read it is:

• left to right = lower-pitched to higher-pitched sounds;
• top to bottom = quieter to louder sounds;
• the marks show the softest level you responded to;
• the right and left ears are plotted separately.

The lower a point appears on the graph, the louder the sound had to be before you heard it.

An audiogram is very useful, but it does not explain the cause of a hearing problem by itself.

What does the horizontal axis mean?

The horizontal axis shows frequency, or pitch.

Lower frequencies are more like a low hum or bass sound. Higher frequencies are thinner or sharper sounds.

Speech contains many different frequencies. This is why someone may hear that another person is talking but still miss parts of words when certain frequencies are harder to hear.

What does the vertical axis mean?

The vertical axis shows hearing level in decibels.

The layout feels backwards at first: quieter sounds are near the top and louder sounds are lower down.

If a point is higher, you heard that pitch at a softer level. If it is lower, the sound needed to be louder.

Do not use one number to diagnose yourself. The audiologist looks at the complete pattern, both ears, your symptoms and other test results.

Why are the two ears shown separately?

Each ear is tested on its own.

That helps show:

• whether the ears are similar;
• whether one ear is noticeably worse;
• which pitches are easier or harder to hear;
• whether the pattern is even across frequencies.

If one ear has become clearly worse than the other, especially suddenly, mention that separately to the clinician.

What are air and bone conduction?

Air conduction

This is the familiar test using headphones or insert earphones. Sound travels through the outer and middle ear to the inner ear.

Bone conduction

A small vibrator is placed behind the ear. It sends sound to the inner ear while partly bypassing the outer and middle ear.

Comparing the two helps the clinician understand where sound transmission may be affected.

For a patient, the key idea is simple: these are two routes used to work out how sound is reaching the hearing system.

What does “normal audiogram” mean?

It usually means your pure-tone thresholds fall within an expected range.

But it does not always mean listening is easy in every real-world situation.

Pure-tone testing is done in quiet. Real life includes restaurants, traffic, several people talking, music and room noise. Some people can have thresholds within the expected range and still struggle to understand speech in noise.

In that situation, the clinician may discuss speech testing or speech-in-noise testing.

What does an audiogram show well?

It can help show:

• the quietest tones each ear can detect;
• which frequencies are affected;
• differences between the ears;
• the relationship between air and bone conduction;
• whether further assessment may be useful.

What does it not fully explain?

An audiogram alone does not always explain:

• why speech is difficult in noise;
• why tinnitus is present;
• the exact cause of hearing loss;
• the full impact on everyday communication;
• which hearing aid would suit a person without further assessment.

Frequently asked questions

One point is lower than the others. Is that definitely a problem?

Not necessarily. The full pattern, reliability of responses and testing conditions matter.

Which ear matters more?

Both. They are tested separately because differences can be clinically important.

Can an online hearing test replace an audiogram?

No. It can be a useful screening tool, but it does not replace clinical audiometry in controlled conditions.

Why do I still ask people to repeat themselves if my audiogram is normal?

Pure-tone audiometry measures quiet tones in quiet conditions. Speech understanding can require additional testing, especially if noise is the main problem.

Does the audiogram alone tell me whether I need a hearing aid?

No. The decision also depends on speech understanding, daily listening needs, ear health and your goals.

Hearing assessment in Almaty

Ekaterina Vladimirovna Kravchenko provides pure-tone audiometry and comprehensive adult hearing assessment in Almaty. The goal is not just to hand you a graph, but to explain what it means in plain language and what the next step should be.

Related pages:

• Pure-tone audiometry;
• Comprehensive adult hearing assessment;
• Why speech in noise can be difficult with a normal audiogram.