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Audiometry is an essential means of assessing hearing thresholds in patients with hearing loss. The audiogram quantifies and visually displays a patient's degree and type of hearing loss (sensorineural, conductive, or mixed). Furthermore, various etiologies of hearing loss may demonstrate characteristic patterns on the audiogram, making this testing modality critical for diagnostic purposes. Audiograms are most useful for objectively identifying deficits in hearing by looking at how sound travels through the auditory system via air or bone conduction. Air conduction measures sound transmission from the outer ear, through the middle ear, and into the inner ear, where signals are sent to the central nervous system (CNS) for auditory processing. In contrast, bone conduction measures transmission only from the inner ear to the CNS. This activity reviews the interpretation of audiograms and their role in identifying patterns of otologic disease. Objectives: Evaluate the concept of pure tone thresholds and how they are measured during audiometry. Identify air and bone conduction notation on the audiogram and understand the concept of masking. Assess the differences between sensorineural and conductive hearing loss as shown on an audiogram. Access free multiple choice questions on this topic.

More than 16% of adult Americans experience some degree of hearing loss.[1] Accurately diagnosing and managing hearing loss is essential in patients of all ages, whether for safety and quality of life in adults or for developmental reasons in children. Subtle findings in young patients may warrant referral for audiometry, as children with slight hearing impairment may suffer from speech and language delays. Audiometric threshold data, also known as pure-tone testing, have been used clinically since the 1920s to categorize the degree and type of hearing loss. Audiometric testing utilizes various intensities of sound emitted over a range of frequencies to determine deficits in hearing, and results are plotted on a graph known as an audiogram. The configurations and patterns displayed on the audiogram help healthcare providers understand the etiology and severity of a patient's hearing loss. Audiograms are most useful for objectively identifying deficits in hearing by looking at how sound travels through the auditory system via air or bone conduction. Air conduction measures sound transmission from the outer ear, through the middle ear, and into the inner ear, where signals are sent to the central nervous system (CNS) for auditory processing. In contrast, bone conduction measures transmission only from the inner ear to the CNS.[2][3] Despite the ability of this powerful tool to guide clinical practice in managing patients with hearing loss, many healthcare providers have difficulty accurately interpreting an audiogram.[4] This review aims to explore the basic principles of audiometry and discuss the audiogram's interpretation, including examples of common pathologies that can be diagnosed via audiometry.