Hearing impairment physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Hearing impairment}} | {{Hearing impairment}} | ||
{{CMG}} {{AE}} | |||
==Overview== | |||
==Physical Examination== | ==Physical Examination== | ||
===Ear<ref name="pmid33253610">{{cite journal| author=Nieman CL, Oh ES| title=Hearing Loss. | journal=Ann Intern Med | year= 2020 | volume= 173 | issue= 11 | pages= ITC81-ITC96 | pmid=33253610 | doi=10.7326/AITC202012010 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33253610 }}</ref>=== | ===Ear<ref name="pmid33253610">{{cite journal| author=Nieman CL, Oh ES| title=Hearing Loss. | journal=Ann Intern Med | year= 2020 | volume= 173 | issue= 11 | pages= ITC81-ITC96 | pmid=33253610 | doi=10.7326/AITC202012010 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33253610 }}</ref>=== | ||
*[[Weber test|Weber's tuning fork testing]] | *[[Weber test|Weber's tuning fork testing]] | ||
*[[Rinne test|Rinne's tuning fork testing]] | *[[Rinne test|Rinne's tuning fork testing]] | ||
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hearing loss, the sound will lateralize to the better-hearing ear. | hearing loss, the sound will lateralize to the better-hearing ear. | ||
|With [[Conductive hearing loss|conductive]] loss, the patient will not hear the air conducted sound. This AC< BC. | |With [[Conductive hearing loss|conductive]] loss, the patient will not hear the air-conducted sound. This AC< BC. | ||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Geriatrics]] | [[Category:Geriatrics]] | ||
[[Category:Communication disorders]] | [[Category:Communication disorders]] | ||
Revision as of 04:39, 6 May 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
Overview
Physical Examination
Ear[1]
- Weber's tuning fork testing
- Rinne's tuning fork testing
- Finger rub
- Whisper test
- Handheld audiometer
- Mobile apps and smartphones audiometer
| Finger rub | Whisper test | Handheld audiometer | Mobile apps and smartphones audiometer | Weber's tuning fork testing | Rinne's tuning fork testing |
|---|---|---|---|---|---|
| Examiner gently rubs fingers together close to the patient's ear. |
Examiner stands at arm's length (approximately 24 inches) behind the patient. The patient blocks 1 ear himself. Examiner whispers 5-6 letters/number combinations. |
Examiner holds device in patient's ear one at a time. Patient indicates awareness of each tone. | The advancement of science has led to the development of mobile technology-based screening options, such as the use of different mobile apps (for example, uHear, Mimi) and smartphone or tablet-based portable audiometers that can be connected to perform screening for hearing impairment. | Strike a tuning fork and place it on the middle of the forehead. A
normal test produces sound on both sides (no lateralization). |
Strike a tuning fork and place it on the mastoid bone behind the ear. When the patient indicates no further sound, move the still-vibrating
fork to the ear. In a normal test, the patient will still hear air-conducted sound (air conduction will be better than bone conduction). AC > BC |
| A positive result is a failure to identify rub in ≥2 of 6 attempts. | The positive result is failure to repeat ≥3 of the 6 combinations | Positive result is failure to identify either the 1000- or 2000-Hz frequency in both ears or the 1000- and 2000-Hz frequencies in 1 ear. | They generally require supra-aural headphones for monitoring. | In unilateral
conductive loss, the sound will be greater in the affected ear. In sensorineural hearing loss, the sound will lateralize to the better-hearing ear. |
With conductive loss, the patient will not hear the air-conducted sound. This AC< BC. |
- Abnormalities of the tympanic membrane on inspection, such as scarring suggest a history of middle ear disease, and a visible perforation or cerumen impaction may suggest conductive hearing loss.
References
- ↑ Nieman CL, Oh ES (2020). "Hearing Loss". Ann Intern Med. 173 (11): ITC81–ITC96. doi:10.7326/AITC202012010. PMID 33253610 Check
|pmid=value (help).