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#TUNING FORK HEARING TEST HOW TO#

Hearing loss in the examiner can affect results in those tests that utilize hearing comparisons between patient and examiner.

#TUNING FORK HEARING TEST HOW TO#

Inability of the patient to understand how to identify responses or unwillingness of the patient to cooperate during the test can cause inaccurate results.

Poor technique in striking the tuning fork or incorrect placement can result in inaccurate results.

Factors that may impair the results of the examination.

Weber test: Lateralization of tone to one ear indicating loss of hearing on the other side (i.e., tone is heard in the better ear).

Schwabach test: Shortened duration of tone when compared to that heard by the examiner.

Rinne test: Tone heard louder by air conduction.

Bing test: Pulsating sound that gets louder and softer when the opening to the ear canal is alternately opened and closed.

Tumor (e.g., acoustic neuroma, cerebellopontine angle tumor, meningioma).

Trauma to the inner ear (related to exposure to noise in excess of 90 dB or as a result of physical trauma).

Serious infections (meningitis, measles, mumps, other viral, syphilis).

Presbycusis (gradual hearing loss experienced in advancing age).

Ototoxic drugs (aminoglycosides, e.g., gentamicin or tobramycin salicylates, e.g., aspirin).

Congenital damage or malformations of the inner ear.Sensorineural hearing loss related to or evidenced by:.Weber test: Lateralization of tone to one ear, indicating loss of hearing on that side (i.e., tone is heard in the poorer ear).Schwabach test: Prolonged duration of tone when compared to that heard by the examiner.Rinne test: Tone louder or detected for a longer time than the air-conducted tone.Bing test: No change in the loudness of the sound.Otitis media serous (fluid in middle ear due to allergies or a cold).Otitis media (poor eustachian tube function or infection).Otitis externa (infection in ear canal).Obstruction of external ear canal (presence of a foreign body).Conduction hearing loss related to or evidenced by:.Weber test: Same tone loudness heard equally in both ears.Schwabach test: Same tone loudness heard equally long by the examiner and the patient.Rinne test: Longer and louder tone heard by air conduction than by bone conduction ( Note: This result, observed in patients with normal hearing, is also observed in patients with sensorineural hearing loss.).Bing test: Pulsating sound that gets louder and softer when the opening to the ear canal is alternately opened and closed ( Note: This result, observed in patients with normal hearing, is also observed in patients with sensorineural hearing loss.).Normal air and bone conduction in both ears no evidence of hearing loss.Screen for hearing loss as part of a routine physical examination and to determine the need for referral to an audiologist.Evaluate type of hearing loss (conductive or sensorineural).When the test is administered, the patient is askedto tell the examiner the location of the tone heard (left ear, right ear, both ears, or midline) in order to determine whether the hearingloss is conductive, sensorineural, or mixed. The Weber test has been modified by many audiologists for use with electronic equipment. The Schwabach test compares the patient’s level of bone conduction hearing to that of a presumed normal-hearing examiner. The Rinne test compares the patient’s own hearing by bone conduction to his or her hearing by air conduction to determine whether hearing loss, if detected, is conductive or sensorineural. The occlusion effect is absent in patients with conductive hearing loss and is present in patients with normal hearing or with sensorineural hearing loss. The Bing test samples for conductive hearing loss by intermittently occluding and unblocking the opening of the ear canal while holding a vibrating tuning fork to the mastoid process behind the ear. Tuning fork tests are used less frequently by audiologists in favor of more sophisticated electronic methods, but presentation of the tuning fork test methodology is useful to illustrate the principles involved in electronic test methods.Ī tuning fork is a bipronged metallic device that emits a clear tone at a particular pitch when it is set into vibration by holding the stem in the hand and striking one of the prongs or tines against a firm surface. The tuning fork tests described in this monograph are named for the four German otologists who described their use.

They may be performed as part of the physical assessment examination and followed by hearing loss audiometry for confirmation of questionable results. These noninvasive assessment procedures are done to distinguish conduction hearing loss from sensorineural hearing loss.