Most patients walk out of a hearing test holding a sheet of graph paper, nod politely at the explanation, and file it away at home. Then the questions start. What were those X and O marks? Is 40 dB bad? Why does one ear look worse? This guide decodes your audiogram line by line, so the next time someone says “mild sloping to moderate” you know exactly what it means for your daily life.
What do the X and O symbols on my audiogram mean?
An audiogram carries one mark for every pitch tested in each ear. By convention, O is the right ear and X is the left (red for right, blue for left on coloured printouts). Pitch runs along the bottom from left to right — low rumbles like a truck engine on the left, high sounds like birdsong on the right. Each mark shows the softest level at which you detected that pitch during the test.
You may also see arrow-like marks (<, >) or square brackets. Those are bone conduction results, taken with a small vibrator behind the ear, and they help separate middle-ear problems from inner-ear ones — more on that in the FAQ below.
What do the numbers down the side (dB) mean?
The vertical axis is loudness in decibels (dB HL), and it runs upside-down: 0 at the top, 110–120 at the bottom. The lower a mark sits, the louder that sound had to be before you heard it. One useful surprise: 0 dB is not silence — it is simply the softest level an average healthy young adult can detect. Here is how the ranges translate:
| Degree | Threshold (dB HL) | How it feels day to day |
|---|---|---|
| Normal | 0–25 | No real difficulty with everyday speech |
| Mild | 26–40 | Soft voices and distant speech missed; “people mumble” |
| Moderate | 41–55 | Conversation needs effort; TV volume creeps up |
| Moderately severe | 56–70 | Loud, close speech needed; phone calls difficult |
| Severe | 71–90 | Only shouted or amplified speech is heard |
| Profound | 91+ | Speech mostly inaudible without powerful aids or an implant |
What is the “speech banana” and why does it matter?
If you plot every sound of normal conversation on an audiogram, they fall inside a banana-shaped zone roughly between 250 and 8000 Hz and 20 to 60 dB. Vowels sit on the low-pitched, louder end; consonants like s, f, t and th sit high-pitched and soft, at the banana’s thin tip. Even a mild high-frequency loss clips that tip off — which is exactly why so many patients say “I hear, but words are not clear” and why shoe, sue and few start sounding alike. Your marks compared against the banana show precisely which speech sounds you are losing.
What do mild, moderate and severe really mean day to day?
The labels describe sound levels, not suffering levels. A “mild” loss can be a daily struggle for a teacher, a shopkeeper bargaining across a counter, or anyone on back-to-back office calls, while the same numbers may barely bother a retired person in a quiet home. We also increasingly see high-frequency notches in young earphone users — if that is you, read how earphones quietly damage hearing.
A pattern we see often at our Gandhinagar clinic: someone tested three years ago was told the loss was “only mild”, filed the report in a drawer, and returns when phone calls at work have become guesswork. On paper, mild looks harmless; in a noisy office it behaves anything but. The old report then becomes genuinely valuable — comparing it with a fresh audiogram shows how fast things are changing, not just where they stand today.
What should you do with your report now?
Three things. First, keep every audiogram safely — it is your baseline for life. Second, if any marks sit below the 25 dB line, repeat a PTA hearing test in Gandhinagar yearly so change is caught early. Third, if the loss is moderate or worse, discuss management honestly; our guide to hearing aid prices in Gandhinagar (Rs.15,000 to Rs.3,00,000 depending on technology) is a sensible starting point. Or simply send a photo of your report on WhatsApp at 88776 72821 and we will explain it in plain words, free of charge.