Hearing impairment physical examination
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American Roentgen Ray Society Images of Hearing impairment |
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
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