Hearing loss type and severity - the audiogram explained

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You’ve had your first audiology evaluation…you’ve been given a chart…now what? Your doctor has probably given you a document called an audiogram. This document is how your audiologist has tested your hearing, identifying hearing thresholds, and if a loss is present, hearing loss type and severity. This information can be used to help generate a plan to help you re-gain access to sounds. But before we dive into the world of treatment, let’s learn more about what is documented on the audiogram.

What is conductive hearing loss?

Conductive hearing loss occurs when there are problems in the outer or middle ear. This type of loss is usually mild to moderate, and can often be treated successfully with medication or surgery.

What is sensorineural hearing loss?

Sensorineural hearing loss results from damage to the cochlea and inner ear. It is often referred to as “nerve deafness” and is the most common type of hearing loss, responsible for about 90 percent of cases. Sensorineural hearing loss is incurable but can usually be treated successfully with hearing aids.

What is mixed hearing loss?

Mixed hearing loss is a combination of both conductive and sensorineural hearing losses. Patients experience problems with the middle and outer, as well as the inner, ear. Treatment might include medications, surgery or hearing aids.

So a loss has been identified, what is meant by severity?

The degree of hearing loss refers to its severity. Hearing loss is measured in decibels (dB) and ranges from normal to profound. It is classified as follows:

  • Normal -10 to 15 dB

  • Slight 16 to 25 dB

  • Mild 26 to 40 dB

  • Moderate 41 to 55 dB

  • Moderately severe 56 to 70 dB

  • Severe 71 to 90 dB

  • Profound 91+ dB

What does the audiologist mean when they talk about a hearing loss configuration?

Hearing loss configuration refers to the pattern of loss across frequencies as charted on a patient’s audiogram. An individual whose loss affects the high tones is described as having high-frequency hearing loss; the configuration would show good hearing at lower pitches and poor hearing at higher pitches. Other types of hearing loss configurations include:

  • Bilateral (hearing loss affects both ears) vs. unilateral (single-sided hearing loss)

  • Symmetrical (hearing loss is similar in both ears) vs. asymmetrical (hearing loss can vary in degree and configuration in each ear)

  • Progressive (a steady decline in hearing ability) vs. sudden (hearing loss occurs rapidly and without warning)

  • Fluctuating (hearing loss changes over time; it may get worse or better) vs. stable (hearing loss remains the same)

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Jody Vaynshtok

Jody is a California-licensed speech language pathologist with eight years of industry and clinical experience. She has worked with both adult and pediatric populations during her time at private practice, birth-to-three, and hospital facilities. She is experienced in the assessment and treatment of a variety of communication and cognitive disorders. In addition, Jody has a passion for working with adults looking to achieve clearer communication. Jody received her BS in Speech and Hearing Sciences and MS in Medical Speech-Language Pathology from the University of Washington. She was a part of the Lucile Packard Children’s Hospital at Stanford’s cleft and craniofacial clinic participating in the multidisciplinary assessment and treatment of children born with craniofacial abnormalities. She holds a staff position at UCSF and is the lead speech language pathologist for the department of Otolaryngology-Head and Neck Surgery’s Hearing Loss Clinic. When she's not busy having fun with her clients Jody enjoys spending time with her husband, Anton, friends and family. And if she's not headed out somewhere fun for dinner, you might find her at Bar Method working out!