4/7/2023 0 Comments Weber tuning fork testThis pattern is the same to what is found in people with normal hearing, but patients with sensorineural hearing loss will indicate that the sound has stopped much earlier. In sensorineural hearing loss the ability to sense the tuning fork by both bone and air conduction is equally diminished, implying they will hear the tuning fork by air conduction after they can no longer hear it through bone conduction.This indicates there is something inhibiting the passage of sound waves from the ear canal, through the middle ear apparatus and into the cochlea (i.e., there is a conductive hearing loss). If the patient is not able to hear the tuning fork after it is moved from the mastoid to the pinna, it means that their bone conduction is greater than their air conduction (BC>AC).This normal result is paradoxically called a positive Rinne test (as a positive medical test usually indicates an abnormality). Air conduction should be greater than bone conduction (AC>BC), so the patient should be able to hear the tuning fork next to the pinna (outer ear) after they can no longer hear it when held against the mastoid.The patient is then asked again to indicate when they are no longer able to hear the tuning fork. Once the patient signals they can't hear it, the still vibrating tuning fork is then placed 1–2 cm from the auditory canal. The Rinne test is performed by placing a 512 Hz vibrating tuning fork against the patient's mastoid bone and asking the patient to tell you when the sound is no longer heard. People with sensorineural hearing loss speak loudly, because they can’t hear themselves.Placement of the tuning fork in front of the ear, to test air conduction. Have you noticed how we whisper during airplane descents (conductive loss due to Eustachian Tube dysfunction).Something to Notice People with conductive hearing loss speak quietly (because they hear themselves so well). Rinne - Right Ear: BC > AC Left Ear: AC > BCĢ.Decreased hearing on Right (by whisper test or audiometry).If there’s a hearing deficit in an ear, but no conductive deficit, then the hearing disorder is sensorineuralĬlinical Scenarios 1.If AC > BC, there’s no conductive deficit.If BC > AC (or if BC = AC), there’s a conductive deficit in that ear.** Air conduction (AC) is normally greater than bone conduction (BC) If #1 is louder, bone is greater than air (BC > AC).If #2 is louder, air conduction is greater than bone (AC > BC).
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