Pure Tone Audiometry — commonly called a PTA test or simply an audiometry test — is the cornerstone of audiological assessment. It is the most informative single test available for evaluating hearing, and every hearing aid fitting should be based on a current, accurate audiogram. In Rawalpindi and across Pakistan, PTA is the standard test performed at audiological clinics and ENT departments. This guide explains exactly what happens, what the results mean, and why the quality of the test matters.
What is Pure Tone Audiometry?
Pure Tone Audiometry measures the quietest sound you can detect across a range of frequencies (pitches). 'Pure tones' — single-frequency beeps — are presented at different volumes (intensities) through headphones. The test maps your hearing threshold at each frequency: the minimum sound level you can just barely detect. The result is plotted on a graph called an audiogram, which gives a complete picture of your hearing.
Frequencies Tested in a PTA Test
Standard audiometry tests hearing at frequencies from 250 Hz (low bass tones) to 8,000 Hz (high-pitched sounds). Extended high-frequency audiometry goes up to 16,000 Hz and can detect very early noise-induced damage before it affects speech hearing. The frequencies most critical for understanding speech are 500 Hz, 1,000 Hz, 2,000 Hz, and 4,000 Hz — together called the speech banana on an audiogram.
| Frequency (Hz) | What You Hear at This Pitch | Common Sound |
|---|---|---|
| 250 Hz | Very low bass | Refrigerator hum |
| 500 Hz | Low tones | Vowel sounds (U, O) |
| 1,000 Hz | Mid-low tones | Vowels (A, E, I) |
| 2,000 Hz | Mid tones — critical for speech | Consonants (D, N, B) |
| 4,000 Hz | Mid-high — most affected by noise damage | Consonants (S, SH, F) |
| 8,000 Hz | High pitch | Birds chirping, cicadas |
How is a PTA Test Performed? Step by Step
- 1Otoscopy: The audiologist first examines both ear canals with an otoscope to check for earwax or blockages that could affect results
- 2Headphone placement: Standard supra-aural or insert headphones are placed on or in each ear
- 3Air conduction testing: Tones are played through the headphones — you press a button or raise your hand each time you hear a sound, no matter how faint
- 4Bone conduction testing: A small vibrator is placed behind the ear on the mastoid bone — this bypasses the outer and middle ear to test the inner ear (cochlea) directly
- 5Masking: White noise is introduced in one ear to prevent it from 'hearing' sounds presented to the other ear — ensures accurate results when there's a difference between ears
- 6Results plotted on an audiogram: Each frequency threshold is marked with standard symbols (O for right ear, X for left ear) at the intensity where you just barely heard the tone
Reading Your Audiogram: What the Results Mean
The audiogram has frequency on the horizontal axis (low to high, left to right) and hearing level in dB HL on the vertical axis (quiet at top, loud at bottom). Normal hearing falls between 0 and 25 dB HL at all frequencies. Here's how hearing loss is classified:
| Degree | dB HL Range | What You Miss |
|---|---|---|
| Normal | 0 – 25 dB | Nothing — hearing is within normal limits |
| Mild | 26 – 40 dB | Soft speech, consonants in quiet environments |
| Moderate | 41 – 55 dB | Conversational speech at normal level |
| Moderately Severe | 56 – 70 dB | Loud speech, most conversation without amplification |
| Severe | 71 – 90 dB | Only very loud sounds, shouted speech |
| Profound | 91+ dB | Almost nothing — cochlear implant candidacy |
PTA Test vs Full Audiological Evaluation: What's the Difference?
Pure Tone Audiometry alone shows what you can hear — but a comprehensive audiological evaluation includes additional tests. At Ideal Hearing Care Center, a full evaluation includes: PTA (pure tone thresholds), Speech Audiometry (testing how well you understand words and sentences), Tympanometry (checking middle ear function — can identify fluid, perforation, Eustachian tube problems), and Acoustic Reflex Testing (assessing the stapedial reflex to differentiate types of hearing loss). Together, these tests take 45-60 minutes and provide everything needed for accurate diagnosis and hearing aid selection.
Why the Quality of Audiometry Matters
Not all audiometry is equal. A hearing test performed with uncalibrated equipment, in a noisy room, or by an untrained technician can be significantly inaccurate. Hearing aids fitted to an inaccurate audiogram are incorrectly programmed — which is why some patients say 'hearing aids don't help me' when in reality the problem was the quality of their initial test. At Ideal Hearing Care Center, we use internationally calibrated audiometers in a sound-treated environment, with qualified audiologists performing and interpreting the tests.
Real Ear Measurement (REM) — checking that the hearing aid actually delivers the right sound levels in your ear canal — is the final step. Without REM verification, hearing aids are statistically fitted correctly only 30-40% of the time. We perform REM on every fitting.
Frequently Asked Questions About Pure Tone Audiometry
How long does a pure tone audiometry test take?
The PTA test itself takes approximately 20-30 minutes for both ears. A complete audiological evaluation including speech audiometry and tympanometry takes 45-60 minutes. Results are available immediately, with an audiogram printout and verbal explanation at the end of the appointment. We ask patients to arrive 10 minutes early to complete a case history form.
Do I need a referral for an audiometry test in Rawalpindi?
No referral is needed at Ideal Hearing Care Center. You can book directly by calling 051-6137199 or WhatsApp 0328-0000510. We see patients referred by ENT doctors, paediatricians, and neurologists, as well as self-referred patients who notice hearing difficulties. A hearing evaluation is available for patients of all ages — from newborns to elderly — without any referral requirement.
What does a 'sloping audiogram' mean?
A sloping audiogram — where hearing thresholds are normal or near-normal at low frequencies (250-500 Hz) but progressively worse at high frequencies (2,000-8,000 Hz) — is the classic pattern of noise-induced or age-related hearing loss. It means you still hear the low-frequency components of speech (vowels, voice quality) but miss the high-frequency consonants (S, F, SH, TH, CH) that carry the meaning of speech. This explains the classic complaint: 'I can hear people talking but can't understand the words.'
Can I fail a hearing test?
An audiometry test is not a pass/fail test — it is a diagnostic measurement, like a blood test. Your audiogram simply shows what your hearing levels are at each frequency. There are no 'wrong' responses. Even if your results show significant hearing loss, this is valuable clinical information that allows the audiologist to recommend the right treatment. Think of the audiogram as a map — not a report card. The earlier the map is drawn, the earlier the right path can be planned.
Where is the best place to get an audiometry test in Rawalpindi?
Ideal Hearing Care Center provides comprehensive, calibrated Pure Tone Audiometry in Rawalpindi — opposite Gate #1 of Holy Family Hospital, E-Block Satellite Town. We use ANSI/ISO certified audiometers in a sound-treated test environment. Our audiologists provide detailed explanation of results and a printed audiogram the same day. We serve patients from Satellite Town, Saddar, Bahria Town, Faizabad, Raja Bazar, Saidpur Road, Cantt, and across Islamabad.
Visit Ideal Hearing Care Center — Rawalpindi's Audiometry Specialists
Office #1, Ground Floor, Opposite Gate #1 Holy Family Hospital, Rajput Street, E-Block Satellite Town, Rawalpindi. Open Mon–Sat: 10:00 AM – 9:00 PM. Call 051-6137199 | WhatsApp 0328-0000510.