#Tuning fork test vs rinne how to#

Large ear canal volume suggests patent pressure equalization tube or perforated eardrum. Small ear canal volume suggests ear canal occlusion. The Jerger system is commonly used to classify tympanometric results: For example, acoustic trauma (noise-induced loss) often results in a loss centered around 4 kHz with recovery at higher frequency (i.e., a 4-kHz notch) presbycusis often involves symmetric downsloping loss, worse at higher frequency a fluctuating low-frequency loss is often seen with Ménière′s disease. Patterns of SNHL may be suggestive of certain etiologies, taken together with clinical history and exam. Basic Otorhinolaryngology: A Step-by-Step Learning Guide. (c) The type C tympanogram has a peak in the negative pressure region below −100 daPa, consistent with impaired middle ear ventilation.

A type B tympanogram with large volume is seen with the perforation. This indicates immobility of the tympanic membrane, which may be due to fluid in the middle ear or tympanic atelectasis. (b) The type B tympanogram is flat or has a very low, rounded peak. (a) The normal tympanogram has a prominent, sharp peak between +100 and −100 daPa. 3.8 Normal and abnormal tympanogram patterns. A poor word-recognition score, especially out of proportion to pure tone thresholds, suggests possible retrocochlear pathology, such as an acoustic tumor. In a sensorineural loss, bone conduction thresholds typically equal air conduction, and the loss may be due to dysfunction at the level of the cochlea, CN VIII, or central pathways. The loss may be due to dysfunction involving the external canal, tympanic membrane, or ossicular chain or to middle ear fluid. In a conductive loss, there is an air–bone gap on the audiogram, with better bone conduction thresholds, with appropriate masking. Otologic disease may be categorized as conductive hearing loss, sensorineural loss (SNHL), or mixed hearing loss. Red flags should prompt referral to an otolaryngologist (discussed below). 3.8) may suggest various forms of otologic disease. Results of the audiogram and tympanogram ( Fig. (Used with permission from Probst R, Grevers G, Iro H.

#Tuning fork test vs rinne how to#

(d) Audiogram showing mixed hearing loss. 1 Introduction How to perform Rinne’s test How to perform Weber’s test Interpretation of Rinne’s and Weber’s tests Conductive vs sensorineural hearing loss Key points Improve Article Introduction Rinne’s and Weber’s tests are simple tuning fork tests used to screen for the presence of conductive and sensorineural hearing loss. (c) Audiogram showing sensorineural hearing loss. (b) Audiogram showing conductive hearing loss. The procedure of performing the tuning fork vibration test is that the fork is placed on the forehead of the person being tested and if the sound resonates on one side but not on the other side then the test indicates the patient may be suffering from the ipsilateral conductive hearing loss or contralateral sensorineural hearing loss. It is necessary to employ masking (a static type of noise) in certain situations to prevent the nontest ear from detecting the test signal. A Rinne test should always be accompanied by a Weber test to also detect sensorineural hearing loss and thus confirm the nature of hearing loss. An audiogram is a graph with frequency (in Hz) plotted on the x axis and intensity (in dB) plotted on the y axis. In a patient with a profound, unilateral sensorineural hearing loss, there may be a false negative Rinne due to the response of the normal ear i.e., AC>BC in the affected ear, but both of these thresholds are elevated relative to BC in the normal ear, so the patient reports that bone conduction is louder (they're actually hearing the tone in their normal ear, rather than their tested - i.e.Results of audiometric testing are typically plotted on an audiogram ( Fig. In a person with a conductive hearing loss, bone conduction is greater than air conduction (BC > AC bone threshold is less than air threshold)

When person can no longer hear the sound (bone conduction threshold), place the tuning fork near the ear canalĪsk when the person can no longer hear the sound (air conduction threshold)ĭue to the amplification provided by the middle ear, in a normal person air threshold BC) physicians typically use tuning forks of either 256 or 512 Hz (i.e., low frequencies of human hearing), which means that they are testing the stiffness component of the middle ear's acoustic impedance, which is determined by the volume of the middle ear space.Strike tuning fork and place on mastoid process PURPOSE: determination of a conductive hearing loss The Rinne and Weber tests give the clue for the type of hearing impairment either conductive or sensorineural hearing loss.