Prof. Dr. Ahmet Özdoğan
Otology & Ear

Pure-Tone Audiometry

The foundational audiological test measuring hearing thresholds in air conduction (AC) and bone conduction (BC); the AC-BC gap reflects the conductive component, and the sensorineural component reflects cochlear loss.

Within otology and ear disease, Pure-Tone Audiometry is more useful as clinical context than as a single report word. The foundational audiological test measuring hearing thresholds in air conduction (AC) and bone conduction (BC); the AC-BC gap reflects the conductive component, and the sensorineural component reflects cochlear loss. Patient history, objective findings, risk profile and functional loss improve decision quality when reviewed together. the clinical point assessment interprets hearing level, the dictionary entry ear pressure, this topic discharge history, this term dizziness pattern and the finding daily communication impact together. The entry makes this entry safety limits, examination priorities and follow-up logic easier to understand. A clinical view of the clinical point interprets anatomical or symptom definitions together with daily-life impact: Pure-tone audiometry determines the lowest audible sound pressure level (threshold) at frequencies between 250 Hz and 8000 Hz. This keeps repeat testing burden and delayed diagnosis risk in the same frame.

The diagnostic pathway for the dictionary entry uses history, examination and selected testing as complementary steps. If patient-reported change and clinical findings point in different directions, assessment is widened. the dictionary entry review may gather otoscopy, this topic microscopic examination, this term audiometry-tympanometry and the finding temporal bone imaging inside the this entry file. the clinical point interpretation separates hearing type, the dictionary entry eardrum mobility, this topic ossicular chain status, this term vestibular findings and the finding prior infection history. The examination plan for this topic is built around duration, side, progression and associated risks rather than one symptom alone: Degree of hearing loss is classified in dBHL: normal 0-25, mild 26-40, moderate 41-55, moderately severe 56-70, severe 71-90, profound >90 dBHL. Previous reports can therefore improve decision quality. The decision stays safe while avoiding unnecessary investigation burden.

The treatment plan for this term depends on what the finding represents in that patient. Observation, lifestyle adjustment, medication, voice hygiene, allergy control, infection treatment, rehabilitation, endoscopic procedures and the finding surgery are compared within the same decision tree. this entry planning discusses medication or drops, the clinical point hearing aids, the dictionary entry vestibular rehabilitation, this topic tympanoplasty-stapes surgery or this term implant options by finding. Management of the finding aims to improve quality of life while protecting breathing, this entry safety, hearing, swallowing and oncologic risk separately. The goal is a measured pathway that protects safety and function.

After this term, review does not only ask whether the symptom improved; examination findings, functional gain and safety boundaries are compared as well. the finding follow-up tracks hearing change, this entry ear discharge, the clinical point dizziness, the dictionary entry tinnitus burden and this topic quality-of-life impact together. For this term, patients learn which findings can be expected and which changes are linked to reassessment. If the finding recovery changes with this entry changes with ear-area swelling, trauma clues, foul smell or facial weakness, reassessment is prioritized.

Online reading about the clinical point should organize clinical questions rather than decide care; previous tests and treatment responses are easier to use when prepared in chronological order.

Before the next reading, the finding context: current symptoms are not mixed with report wording; examination findings remain central.

During preparation, this entry context: safety interpretation is left to personal examination; examination findings remain central; For terminology clarity, pure-tone assessment, audiometry review, pure-tone report language, audiometry definition work as short review notes.

How to Interpret an Audiogram

The audiogram shows hearing level on the y-axis (dBHL, better at top) and frequency on the x-axis (Hz, lower at left). The air conduction symbol is red O for the right ear and blue X for the left; bone conduction is expressed with < and > symbols. Normal threshold is considered 25 dBHL and below; any value above this level indicates hearing loss.

A flat loss pattern — similar decline across all frequencies — is seen in ototoxicity, sudden hearing loss or Menière's disease. A sloping high-frequency curve is typical for presbycusis and noise damage. When low-frequency loss predominates, the early stage of Menière's or auditory neuropathy spectrum disorder should be considered.

Clinical Use of Audiometry

Pure-tone audiometry alone is an evaluation tool, not a diagnosis; it is interpreted together with tympanometry, speech discrimination testing and OAE. The indication for a hearing aid is generally determined by a 40 dBHL speech frequency average or the threshold of difficulty in understanding speech. In surgical planning (stapedectomy, tympanoplasty), pre- and post-operative audiogram comparison measures success.

In children, play audiometry (2-4 years) or behavioural observation audiometry (6 months-2 years) is used; when cooperation cannot be obtained, threshold assessment with ABR is performed. Annual audiometry programmes in industrial settings are covered by occupational health legislation.

Reliability and Limitations of Audiometry

Pure-tone audiometry requires a standard audiology room or booth with ambient noise controlled (ISO 8253-1). Results are dependent on cooperation; simulation and functional loss tests (Stenger, ABR) can be used to exclude non-organic hearing loss. Failure to follow masking protocols can lead to erroneous results from cross-hearing.

High-frequency audiometry (9-20 kHz) carries additional value for detecting damage outside routine audiometry — particularly in ototoxicity monitoring — at an early stage. Threshold information alone does not fully reflect speech understanding ability; speech audiometry is therefore complementary.

When Should Audiological Evaluation Be Done?

In newborns who do not pass hearing screening, confirmation with diagnostic ABR should be done within 3 months. Audiological evaluation is indicated in preschool children with speech delay, suspected hearing loss or recurrent ear infections.

In adults, sudden or progressive hearing loss, unilateral tinnitus, dizziness, voice change or use of ototoxic drugs are sufficient indications for pure-tone audiometry. Annual mandatory audiometry is recommended for those working in noisy occupational environments.

Frequently asked questions

What is Pure-Tone Audiometry?
The foundational audiological test measuring hearing thresholds in air conduction (AC) and bone conduction (BC); the AC-BC gap reflects the conductive component, and the sensorineural component reflects cochlear loss. Within otology and ear disease, Pure-Tone Audiometry is more useful as clinical context than as a single report word.
When is Pure-Tone Audiometry clinically important?
The diagnostic pathway for the dictionary entry uses history, examination and selected testing as complementary steps. It is considered with audiological and ENT assessment when ear pain, hearing loss, tinnitus, dizziness or ear fullness is present.
When is ENT assessment relevant for Pure-Tone Audiometry?
ENT assessment becomes relevant if symptoms last more than a few weeks, become one-sided or progressive, or are accompanied by breathing, swallowing, voice, hearing or neck-mass findings.
What information helps assessment of Pure-Tone Audiometry?
It is useful to note when symptoms started, which side is affected, previous operations or treatments, current medication, imaging and test reports, and the effect on daily life. It is considered with audiological and ENT assessment when ear pain, hearing loss, tinnitus, dizziness or ear fullness is present.

Learn more about this procedure

Detailed guide from Prof. Dr. Özdoğan's clinic

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References

This glossary entry is for informational purposes only and does not constitute medical advice. Consult a qualified specialist for diagnosis and treatment.

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