Hearing Test Discrepancy

[mmu]

Hello everyone!

I need some explanation about the hearing tests. Due to the 6 months long waiting time in the region I live in I managed to get a hearing test appointment in a clinic in Oslo after waiting for 2 months. I have had my hearing tests done yesterday. The test result shows that I have a dip in my hearing for both ears at the higher frequencies which are above 4 kHz up to 8 kHz. I have questions about the the way tests were conducted. I am sure many of you have a good knowledge about it. So please give me some explanations on the followings:

The hearing tests were done in two phases. First some tone was played and I had to press a button every time I heard it. My question is delaying to press the button can effect the test result?

Second phase of the tests was conducted by playing some words which I had to repeat after. The words were clearer when it was played louder and I repeated what I thought I heard. But then when it got very mild I could hear the words being said but I didn't understand what the words were exactly and that is why I kept silent. I am wondering, can this silence came up as the dip for higher frequencies?

Will really really appreciate your replies.

 

[GregCA]

The hearing tests were done in two phases. First some tone was played and I had to press a button every time I heard it. My question is delaying to press the button can effect the test result?

The technician sends you a tone and waits for you to press the button: if you press right away, it's a strong indication that you heard the tone. The technician waits for a bit and then offers the tone at higher volume. If it takes you a long time to answer it shows some level of uncertainty, so you're probably on the edge of the volume, which means it doesn't matter so much if it's considered a heard/not heard, as it would fall within the margin of error.
In other words, I wouldn't worry about it. If it took you time to press the button, then it's because you legitimately didn't hear the tone clearly. And it's not a race: the goal isn't to get the highest score: it's to get what best represents your hearing.

Second phase of the tests was conducted by playing some words which I had to repeat after. The words were clearer when it was played louder and I repeated what I thought I heard. But then when it got very mild I could hear the words being said but I didn't understand what the words were exactly and that is why I kept silent. I am wondering, can this silence came up as the dip for higher frequencies?

This test is word recognition test and does not affect the audiogram results (the curves that come out of Pure Tone Audiometry): it is generally shown in a separate section of the result sheet, sometimes as a percentage of success.

I have inquired my neurotologist about the meaning of those tests (in particular for my case), and what he told me is that a good score at word recognition (and other tests "in noise") is an indication that the hearing nerve is in good shape. You can have significant hearing loss (say, from hair cell loss) and have a well functioning hearing nerve. That seems to be my case, according to him.

 

[1MW]

That you describe is acoustic trauma.
Upload your audiogram.

 

[mmu]

Thank you @GregCA for your explanation. It was not word regnition they have conducted rather SRT (Speech Reception Threshold)

Please see my audiogram.

 

[mmu]

@1MW, I have just uploaded the audiogram.

 

[mmu]

There is one thing the ENT specialist told me while handing me over the audiogram is that the dip could be due to aging (I am 36 now) or it could be due to genetics. Having a non-european ethnicity he meant probably this kind of hearing loss is normal for people with ethnic origin as myself. Is it possible? Hearing capability and hearing loss vary from ethnicity to ethnicity?

 

[GregCA]

There is one thing the ENT specialist told me while handing me over the audiogram is that the dip could be due to aging (I am 36 now) or it could be due to genetics

I wouldn't expect a 36 year old to have 50 dB loss @ 8 kHz. Genetics maybe but why not accept the simpler explanation that you've stated in your profile? Ear infections are known to have the ability to damage hearing. Any reason it wouldn't be the likely cause?

 

[mmu]

You are right that I mentioned ear infection. I mentioned it as I thought it could be a possible cause. I had ear infection when I was kid. But the tinnitus I am experiencing started for 2 months ago while I was going through a very stressful period. The ENT also mentioned that may be the stress is the only reason behind it.

 

[dingaling]

The speech graph suggests you had a "speech-in-quiet" test where you heard simple words at varying intensities. Usually, the audiologist scores for each "bit" of a word you said correctly so if for example, the word was "dog" and you said "g", the audiologist would score you 1 point. If you were silent, you would score 0.

Don't worry though, the speech test agrees with the audiogram reasonably well

 

[mmu]

@dingaling thank you for explaining it. But your last sentence is not clear to me though. Even though I was silent during part of the SRT test (during the low intensity) the audiogram shows no effect of it?

 

[dingaling]

@dingaling thank you for explaining it. But your last sentence is not clear to me though. Even though I was silent during part of the SRT test (during the low intensity) the audiogram shows no effect of it?

Sorry, tecchie speak...

The purpose of doing a speech-in-quiet test is to see how many words you can repeat back correctly (or in part) at the quietest level 50% of the time - similar to the beep test which identifies how many beeps you can respond to at quiest levels 50% of the time.

The results of the speech test and beep test should be comparable to one another