For some people, having their hearing tested can be a daunting thought, but it really doesn’t have to be. We’ve heard many a musician put it off, fearing the worst, but more often than not it brings good news – and more importantly, reassurance and empowerment in equal measure. Your audiologist is there to guide and support you through life-long love of music. If you’re ready to make them your best friend, here’s what to expect, and how to interpret the results they give you.
The Hearing Test
A hearing test, or audiogram, is usually (hopefully) performed by an audiometrist or audiologist in a sound-proof, or very very quiet room. There are four main components to it, they are:
- Otoscopy: this involves taking an otoscope, or ear light, looking into your ear to evaluate it’s health from the outside. Here your audiologist will check for anything from earwax to potential infections that may need medical attention.
- Audiometry: This is the main component of the hearing test. Here the audiologist will place headphones on your ears (or small earbuds in them) and instruct you to press a button whenever you hear a beep. It’s important to press this even for the softest ones you hear, as it helps them find your hearing threshold. This is the softest sound you can hear at any test frequency, where you respond at least 2 out of 3 times. Standard test frequencies are between 250 and 8000 Hz, however, we believe testing the extended high-frequencies, 9 to 16000 Hz, is both relevant and important for musicians or music industry workers. This is for two reasons, firstly the extended high-frequencies are susceptible to sound over-exposure, and for many injury to hearing will show here first. Monitoring these frequencies can assist from a conservation perspective. Secondly, these frequencies are rich with harmonics and overtones that add to the wonderful tone and timbre of instruments – worth protecting, right? Ask you audiologist if they can include these in your next hearing test for a more complete picture.
- Speech: You may also have your ability to understand speech tested. This is usually done by playing a list of one-syllable words into your ears, and asking you to repeat them back one at a time. Another, more real to life version, is called the Listening in Spatialised Noise Sentences test. This can help assess how you go understanding speech in the presence of lots of background sound, and requires you to repeat back one sentence at a time while much competing noise plays.
- Tympanometry: This test is a measurement of how well your middle ear system moves. If you look into the ear canal, at it’s deepest point there is a thin ear drum, and behind it a cavity of air. By playing a low pressurized sound into your ear, the audiologist can measure how flexible the middle ear space is behind your ear drum. If healthy, the space is air-filled, allowing the many small bones, muscles and ligaments in it to move freely – transmitting sound (see How Hearing works). If it’s congested on the other hand, like during a heavy cold, the audiologist will be able to measure this report back to you and your GP.
These are just a handful of the things your audiologist can do to help your ears stay safe in music. They can also provide you with personalised information on your ears, hearing and exposure, take ear impressions for earplugs (see Hearing Protection) and remove wax safely. Many also specialise in areas such as tinnitus counselling, balance function or hearing amplification. Regardless of your needs, once you’ve had your first hearing test you get the benefit of having a baseline measurement all other tests can be compared back to.
For anyone working in and around the music industry, we recommend a hearing test every two years.
Understanding the Results
Knowing how to read a hearing test isn’t always necessary, however, for any visual learners, it can be helpful to understand the graph used by audiologists to classify your hearing. Using the image below, these points should help demystify the process so you know what you’re looking at.
- Volume: On the left hand side volume is represented, ranging from incredibly soft (0 dB HL) to the sound of a roaring jumbo-jet (120 dB HL).
- Frequency: The top line shows each frequency tested, starting from the bottom of the piano at the left hand side, slowly working our way up in pitch as we move across to the right. At each vertical line, a different and higher pitch is represented.
- Ears: Roses are red, and so is your right ear, apparently. The red crosses represent this persons hearing in their right ear. The blue circles, on the other hand, represent the hearing in their left ear. The closer each zero or cross is to the quiet zero line, the better that persons hearing is at the corresponding pitch. by the same token, the further each cross or circle is from that line, the greater their degree of hearing loss.
- Interpretation: For every pitch measured, anything at or above 20 dB HL (i.e. closer to 0) is considered normal hearing, everything below that shows a degree of hearing loss, working in stages through mild (20 < 40 dB HL), moderate (40 < 70 dB HL), severe (70 < 90 dB HL) and profound (90 dB HL +).
- Impact: We’ve over-layed the below graph with English Phonemes. Their positioning shows how loud they are, and in the general frequency area they usually arise for normal, conversational level speech. For this person, the letters ‘m’ and ‘d’, sit well underneath the cross and circles and therefore, audible. The ‘s’ and ‘f’, however, are above the line. This means they are softer than what the person can hear, making them inaudible speech sounds. A person with this shape of haring loss might find words such as ‘funny’ and ‘sunny’ sound the same unless they can see the speakers lips moving, giving them a clue.
The Next Steps
The best care for your ears involves putting in place practices that ensure longevity in music. We recommend:
- Testing your hearing every two years;
- Having your ears cleaned of wax by a trained professional (when needed) using manual removal;
- Talking to your audiologist about your instrument, performing and listening needs;
- Investing in the right earplugs for you.
And lastly, please talk talk talk about your hearing. A lack of conversation helps build fear and stigmatisation. If you’re having trouble with your ears, likely someone else is to, if you’re looking to care for them, you just might help someone care for theirs too.