Patterns of hearing Loss according to Frequency

Timothy C. Hain, MD •Page last modified: March 7, 2021

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There are many patterns of hearing loss. Generally clinicians group them along several axes; sensory vs conductive; the severity axis -- mild vs moderate vs. profound; the time axis -- sudden vs progressive vs chronic, and the frequency spectrum that is affected.

Hearing tests (audiograms) provide an XY plot of hearing performance(Y axis) vs. frequency (octaves on X axis).

Roughly speaking, the frequency patterns of hearing loss are divided up into: Low-frequency, mid-frequency, high-frequency, notches, and flat. There are also combinations of the above -- mainly the "peaked", or perhaps inverse-cookie bite, which is a mixture of low and high-frequency, sparing mid-frequency.

Some common audiogram shapes are shown below:

Normal audiogram -- threshold of 0. Noise Notch

Examples of other abnormal hearing patterns are shown below

low frequency cookie
Low frequency (Meniere's) Middle (or "cookie bite") centered on 1K


high flat
High-frequency loss, beginning at 8K. This is common as a result of age. Flat hearing loss in both ears, R is worse. This is not specific - -the ear is just damaged.