Reading Your Audiogram

January 23, 2014

The basic hearing examination is a measure of the softest sounds your ears can perceive, also called the threshold of hearing. The audiogram is a graphic display of these hearing thresholds that paints a picture of your hearing ability. All test results are graphed on the audiogram, with frequency (pitch) increasing from left to right, and intensity (loudness) increasing from top to bottom. Red circles represent the right ear’s response, and blue X’s show the left ear results.



Frequency is measured in Hertz (Hz) and is tested in a range from low (like the sound of a foghorn) to high (similar to the sound of crickets). Each vertical line represents a different and discrete frequency value or tone (a single musical note).

Intensity (Hearing Level)

Intensity is measured in decibels (dB). A response at the uppermost portion of the graph (at zero) indicates the patient was able to hear the softest sound the testing machine could make. The further down the audiogram a mark appears, the greater the degree of hearing loss.

In the audiogram on page one, each O or X on the test form corresponds to the softest sounds heard at the testing frequency. For example, the O at 500 Hz shows that the right ear heard a sound at 50 dB. The X at 500 Hz appears at 60 dB, indicating slightly worse hearing in that ear at the same frequency.

Degrees of Hearing Loss

Hearing is classified on a continuum from normal to profound hearing loss. Our sample audiogram shows a moderate hearing loss in the right ear and a moderate to severe loss in the left.

Additional Testing

Speech discrimination is a measure of how well an individual understands single words when tested at his or her comfortable listening level with no background noise. Speech discrimination scores generally reflect how well the patient will understand conversation when wearing hearing aids.


Uncomfortable loudness testing determines the maximum loudness levels that your ears can tolerate without experiencing pain. Each ear is tested using both speech and tones. The intensity of each sound is gradually increased until the patient deems it uncomfortably loud. The audiologist uses information from these tests when programming hearing aids to ensure patient comfort in all listening situations.

Visit Our Updated Website!

January 20, 2014

Hearing Aid Services of HollywoodWe have just completed refreshing the entire content of our website to reflect the latest advances in auditory research and the hearing aid industry. Even those of you who have read the articles wiIl benefit from another look, as much of the text has been rewritten.

The website offers visitors a wealth of information geared for both novice and experienced hearing aid wearers. For example, those who have just begun to explore how hearing instruments could enhance their lives will gain from essays like “The Power of Today’s Hearing Aids,” “Untreated Hearing Loss,” and “Invisible-in-the-Ear Hearing Aids.”

Those who have experience wearing hearing aids should investigate the section entitled For Our Patients. Articles there address topics like what to do when your hearing aids stop functioning and do’s and don’ts for hearing aid care. In addition, the section that covers assistive listening provides valuable tips that make telephone conversations easier. Check out “How to Get a Free Amplified Phone” and “CaptionCall Phone.”

So, please visit (or revisit) As always, I welcome any suggestions you may have.

Over 70 Years in Business: What makes Hearing Aid Services of Hollywood special?

October 22, 2013

Jeff Grama, M.A., who purchased the practice in 1983, has over 35 years experience in audiology, and hearing aid fitting and servicing.
Each patient receives personal attention from Jeff Grama on every visit.
The practice has thrived for decades because we select the best hearing aids for the patient’s individual situation. Our approval rating is consistently above 98%.
We provide state-of-the-art technologies, offered by the premier manufacturers, only after they have passed our careful scrutiny. This includes in-house testing and conducting trials of new instruments on volunteer patients in real world conditions.
Our competitive pricing policy and payment plans make purchasing easy on the budget. The most popular option is twelve-month no interest financing (OAC).
Many hearing aid repairs can be completed in our office. Hearing Aid Services of Hollywood is one of the few audiology practices nationwide that has been granted license by the leading manufacturers to perform on-site warranty repairs.

Secrets to Hearing Better with Your Hearing Aids

October 10, 2012

Secret4Since the advent of the digital age, new hearing instruments have been introduced every year that are better able to cope with extraneous noises in difficult listening situations. However, there still may be times when understanding speech is challenging. The good news is, in most instances, you can modify your environment or position to improve your listening performance. Here are some tips:

When conversing at a noisy gathering, isolate background noise by moving away from the center to the edge of the room. Position yourself so the throng of people is behind you. This will assist your hearing aids’ noise reduction circuitry and directional microphones in locating the voice of the speaker in front of you.

Hearing in restaurants can be a unique challenge. Always request a booth or a table away from the kitchen and main traffic areas. If the restaurant has piped-in music, choose a table away from a ceiling speaker. Opt for an indoor table rather than patio seating, as it is difficult for hearing aids to isolate speech in the presence of traffic noise.

If you have difficulty hearing in a house of worship, it is likely due to the poor acoustics of the facility. Try sitting near a speaker at the front of the room to cut down on interfering echoes. You should be aware that all meeting facilities are required by federal law (Americans With Disabilities Act) to provide an assistive listening system for hearing-impaired members of the congregation. If yours doesn’t have one, you should ask that one be provided.

Most instruments sold within the past year can be coupled with an additional system that will stream the sound of the speaker directly into your hearing aids. This product consists of a wireless microphone worn by the person you want to hear and a small receiver (about the size of a cell phone) worn around your neck. With the microphone placed closer to the speaker’s lips, the loudness and clarity of the voice is enhanced. Our patients find this device most effective in large, loud gatherings, or when trying to communicate in a vehicle, such as a van or bus.

All of us “lip read” to fill in the gaps in conversation when background noise is present. Hearing-impaired people rely on this skill even more than folks with normal hearing do, and they have honed their ability to a fine edge. Always make sure that you can see the face of the person who is speaking to you. Adequate lighting on that person’s face will provide maximum information from lip reading.

Finally and most importantly, don’t be afraid to inform others that you have a hearing problem. Let them know that they should face you, speak a bit slower and rephrase what they say if you misunderstand them. For example, if you don’t understand, “I need to go to the store,” the speaker can rephrase it to, “I need to go the market.” A simple substitution of a key word will often make all the difference.

If you haven’t used these techniques, I think you’ll have fun experimenting with them and find them beneficial. Try them out and feel free to give me your feeback.

Invisible-in-the-Ear Hearing Instruments

August 17, 2012

ladybugI have some news about a recently released product for current patients and those who need hearing aids but have chosen not to wear them. The leading manufacturers have developed an invisible-in-the-canal (IIC) instrument. This design has been the demand of many in the public eye (actors, for example) and for others who, for one reason or another, want an unnoticeable solution for their hearing loss. The outermost portions of IIC products lie out of sight, about half an inch inside the ear canal, so that they are completely invisible. IIC instruments are not like the extended wear hearing aids that I have discussed in other articles (see: “Should You Consider Extended Wear Hearing Aids?” on the Hearing Aid Information section of my website). The new devices are removed nightly and are cared for and stored in the same way as all in-the-ear style hearing aids.

The factories recommend IIC units for those who have a mild to moderate hearing loss and an ear canal of “normal” size and shape. Very narrow, irregularly shaped or child-size ear canals will not allow for placement of the components into the canal. Therefore, patients with ear canals of this type are not suitable candidates for an IIC.  All successful fittings are accomplished with patients who have ear canals that are quite large and have little or no bend.

The manufacturer will offer to make a regular completely-in-the-canal (CIC) style when it is unable to produce an IIC. But naturally, when this occurs, both the patient and I are disappointed. Research and development is ongoing, and I am certain that IICs will continue to miniaturize, making them suitable for smaller ears. In the meantime, please be cautious if you are promised that an IIC can be built for you. What you may be getting is simply a CIC product with a different name.

Many of you have expressed an interest in an invisible product that offers superior performance. To find out if IICs will work for you, if you are located in the greater Los Angeles area, come on in and see us. During your appointment, I will gladly measure a casting of your ear and determine whether you are a candidate.

What Do You Do When Your Hearing Aid Stops Working?

December 28, 2011

Hearing aids follow Murphy’s Rules of Reasoning. That is, when something is going to go wrong, it will happen at the most inopportunetime. However, there are some simple things you can do when your hearing aid doesn’t seem to work properly.

The most common reason a hearing aid will not work is that it’s plugged with earwax or other debris. A plug of wax will prevent the sound from escaping from the speaker port of an in-the-ear aid or the earmold of a behind-the-ear aid, and you’ll think the aid is dead.  However, you can remove the wax plug with the brush or wax loop that came with your hearing aids. If you don’t have cleaning tools, you can use the pointed end of a straight pin to gently dig the wax out.

For those of you who have in-the-ear hearing aids that have wax guard filters installed, the cleaning process is slightly different. The filters are the tiny white plugs that fit into the end of the hearing aid that you insert into your ear canal. Replacement filters are in a 2-inch by 3-inch white or gray packet. When you snap open the top of the packet, you’ll find some black sticks.

Remove one of the sticks and you’ll notice a small white piece on the tip. This is the replacement filter. Take out the old filter with the flattened end of the black stick by pushing it into the old filter and pulling it straight out of the aid. Then, flip over the stick and gently slide the replacement filter into the spot the plugged filter occupied. Usually, this is all that it takes to get your instrument functioning again.

For behind-the-ear users, the problem is often a moisture plug inside of the tubing where the tube inserts into the earmold. You can break the moisture bubble by holding the upper portion of the aid firmly where the earmold tubing attaches to your instrument. Shake it two or three times, as if you were shaking down an old-fashioned thermometer. This force will usually break the moisture bubble and you’ll be back in business.

Of course, if these remedies don’t work, please call (323) 463-7109) or e-mail our office. We’re always ready to help.