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ent audiology

Hearing Loss Grading (WHO Classification)

Grades severity of hearing loss based on average hearing threshold (dB HL) per WHO classification. Guides audiological and surgical referral.

Score interpretation

Normal hearing (< 20 dB) 0

WHO 2021: better-ear average below 20 dB HL.

→ No hearing loss by the better ear; check the worse ear for unilateral loss. Sudden-onset hearing loss: refer immediately (NICE NG98).

Mild hearing loss (20 to < 35 dB) 1

WHO 2021 grade: mild.

→ Treat reversible causes (wax, otitis media); audiology referral if hearing affects daily life. Sudden-onset hearing loss: refer immediately (NICE NG98).

Moderate hearing loss (35 to < 50 dB) 2

WHO 2021 grade: moderate.

→ Audiology referral for assessment and hearing aid fitting; ENT if a conductive or asymmetric component. Sudden-onset hearing loss: refer immediately (NICE NG98).

Moderately severe hearing loss (50 to < 65 dB) 3

WHO 2021 grade: moderately severe.

→ Audiology referral for hearing aids; ENT assessment. Sudden-onset hearing loss: refer immediately (NICE NG98).

Severe hearing loss (65 to < 80 dB) 4

WHO 2021 grade: severe.

→ Audiology and ENT referral; assess for cochlear implant candidacy. Sudden-onset hearing loss: refer immediately (NICE NG98).

Profound hearing loss (80 to < 95 dB) 5

WHO 2021 grade: profound.

→ Audiology and ENT referral; cochlear implant assessment. Sudden-onset hearing loss: refer immediately (NICE NG98).

Complete or total hearing loss (≥ 95 dB) 6

WHO 2021 grade: complete or total.

→ Audiology and ENT referral; cochlear implant assessment. Sudden-onset hearing loss: refer immediately (NICE NG98).

Interpretation bands for the Hearing Loss Grade. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Drugs
Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.