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Earmart Hearing Clinic
Advanced Hearing Care
123 Main Street, City
📞 +91 00000 00000
✉ clinic@earmart.in
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Audiogram
Right Ear
Left Ear
| Key to Symbols | |||
|---|---|---|---|
| Air Conduction | |||
| Unmasked | ○ Right | Masked | △ Right |
| Unmasked | × Left | Masked | □ Left |
| Bone Conduction | |||
| Unmasked | < Right | Masked | [ Right |
| Unmasked | > Left | Masked | ] Left |
| Pure Tone Average | ||
|---|---|---|
| Freq | Right | Left |
| 500 Hz | — | — |
| 1000 Hz | — | — |
| 2000 Hz | — | — |
| PTA | — | — |
| Hearing Classification (WHO) | |
|---|---|
| Normal | ≤ 25 dB HL |
| Mild | 26 – 40 dB HL |
| Moderate | 41 – 55 dB HL |
| Moderately Severe | 56 – 70 dB HL |
| Severe | 71 – 90 dB HL |
| Profound | 91 – 120 dB HL |
| Type of Hearing Loss | ||
|---|---|---|
| Type | Right | Left |
| Conductive | ||
| Sensorineural | ||
| Mixed | ||
| Normal | ||
| Impedance / Tympanometry | ||
|---|---|---|
| Type | Right | Left |
| Type A | ||
| Type As | ||
| Type Ad | ||
| Type B | ||
| Type C | ||
| Relationship of Loss | |
|---|---|
| Bilateral | |
| Unilateral (Right) | |
| Unilateral (Left) | |
| Symmetrical | |
| Asymmetrical | |
| Progressive | |
Audiologist's Remarks / Recommendations: