Tests · Hearing
High-frequency audiometry: what it shows beyond the usual test
High-frequency audiometry measures hearing in the high-pitched sounds that lie above the range covered by conventional audiometry. It is in that region that hearing loss usually begins, before it appears on the standard test. It is therefore used in tinnitus with a normal audiogram, in noise exposure, and in monitoring medications that can affect hearing.
Medically reviewed by Prof. Aline Bittencourt, MD, PhD, CRM-MA 7562 · RQE 1832 Updated on
What is high-frequency audiometry?
Conventional audiometry tests hearing between 250 Hz and 8 kHz. That is the range in which speech occurs, which is why it is the foundational test for establishing whether someone hears and understands.
But human hearing extends beyond that. High-frequency audiometry continues testing at frequencies above 8 kHz, reaching the highest-pitched regions hearing can reach.
Why test sounds we do not use for conversation?
Because that is where loss usually begins. The sensory cells of the cochlea responsible for the highest-pitched sounds are the first to suffer from noise, from certain medications and from the passage of time.
This creates a frequent situation in the clinic: a person complains of tinnitus or of not understanding well in a noisy room, has conventional audiometry, and the result is normal. High-frequency audiometry is the test that reaches that earlier region.
When is it indicated?
- Tinnitus with a normal conventional audiogram. The commonest indication.
- Difficulty understanding speech in noise, without apparent loss on the standard test.
- Noise exposure, occupational or recreational, to follow hearing over the years.
- Use of medications that can affect hearing, monitored before, during and after treatment.
- Follow-up of known hearing loss, to observe its course.
How is it carried out?
The test takes place in the same acoustic room as audiometry, with headphones suited to higher frequencies. You listen to sounds at different intensities and signal whenever you perceive one, however faint — exactly as in conventional audiometry.
It is usually performed in the same session as standard audiometry and adds about fifteen minutes.
How is the result read?
The result is compared with values expected for the person’s age, because hearing at higher frequencies declines naturally over a lifetime. A threshold below what is expected for the age group indicates a change in that region.
Two caveats matter:
- The test does not replace conventional audiometry. It adds information about a range the other does not cover; the two are read together.
- An abnormal result is not a diagnosis. It is a finding, interpreted by the ENT specialist alongside the history, the physical examination and the other tests.
Where it is carried out
At Clínica Rhinus, in the Renascença district of São Luís. The test is performed by the speech-language pathologists on our team and the result is discussed at the consultation with the ENT specialist.
This test is carried out on a self-pay basis only. The consultation and the other tests follow the rules of your health plan. Contact our team to arrange booking.
How should I prepare for this test?
- Bring the medical request: it is required.
- Avoid exposure to loud noise for 14 hours before the test.
- If you have a cold or a blocked ear, let us know when booking — it may be worth rescheduling.
- Bring any previous hearing tests, for comparison over time.
- Tell us if you take or have taken medications that can affect hearing, with names and dates.
Sources: Brazilian Association of Otorhinolaryngology and Cervico-Facial Surgery (ABORL-CCF) · Flint PW, Francis HW, Haughey BH, et al. Cummings Otolaryngology: Head and Neck Surgery. 7th ed. Elsevier; 2020. · Bento RF, Bittencourt AG, Voegels RL. Seminários em Otorrinolaringologia. Fundação Otorrinolaringologia.
Frequently asked questions
Questions about hearing
How does it differ from standard audiometry?
Conventional audiometry tests frequencies from 250 Hz to 8 kHz, which is the range of speech. High-frequency audiometry continues above that, reaching the highest-pitched regions. Because damage to the cochlea usually begins there, the test may detect a change before it appears on the standard audiogram.
When is this test indicated?
In situations where there is a complaint or a risk but conventional audiometry came back normal: tinnitus without apparent hearing loss, difficulty understanding speech in noise, occupational or recreational exposure to loud sound, and monitoring of people taking medications that can affect hearing.
Does the test hurt or need special preparation?
It does not hurt. It is carried out in the same acoustic room as audiometry, with headphones suited to higher frequencies, and you simply signal when you hear the sound. Preparation is the same as for audiometry: avoid loud noise beforehand and let us know if you have a cold.
Does an abnormal result mean I am going to lose my hearing?
No. It shows that there is a change in a region that standard audiometry does not reach, and it serves as a baseline for following hearing over time and for reviewing contributing factors such as noise exposure. Interpretation is always made alongside the clinical picture.