Which tests involve a tuning fork to assess hearing?

Which tests involve a tuning fork to assess hearing?

• A. Weber and Rinne tests
• B. Tympanometry
• C. Otoscope
• D. Acoustic reflectometry

Answer: (A)

Tuning-fork hearing tests use two simple bedside maneuvers to tell apart types of hearing loss and to localize where the issue lies. In the Weber test, you place a vibrating tuning fork on the midline of the skull and ask where the sound is heard best. If a person has a unilateral conductive loss, the sound tends to be heard louder in the affected ear because bone-conducted sound is conducted there more efficiently relative to the air-conduction pathway. If there’s unilateral sensorineural loss, the sound localizes to the unaffected ear since the damaged ear is less capable of perceiving the sound. In the Rinne test, you compare air conduction to bone conduction by placing the fork on the mastoid bone and then near the ear canal once the sound is no longer heard through the bone. For normal hearing or sensorineural loss, air conduction remains better than bone conduction, giving a positive Rinne. For conductive loss, bone conduction becomes louder than air conduction, giving a negative Rinne. The other options are different ear assessments that don’t use a tuning fork: tympanometry measures middle-ear pressure and movement of the eardrum, otoscope is for visually inspecting the ear canal and eardrum, and acoustic reflectometry analyzes how sound reflects off the tympanic membrane to infer middle-ear status.

Tuning-fork hearing tests use two simple bedside maneuvers to tell apart types of hearing loss and to localize where the issue lies. In the Weber test, you place a vibrating tuning fork on the midline of the skull and ask where the sound is heard best. If a person has a unilateral conductive loss, the sound tends to be heard louder in the affected ear because bone-conducted sound is conducted there more efficiently relative to the air-conduction pathway. If there’s unilateral sensorineural loss, the sound localizes to the unaffected ear since the damaged ear is less capable of perceiving the sound.

In the Rinne test, you compare air conduction to bone conduction by placing the fork on the mastoid bone and then near the ear canal once the sound is no longer heard through the bone. For normal hearing or sensorineural loss, air conduction remains better than bone conduction, giving a positive Rinne. For conductive loss, bone conduction becomes louder than air conduction, giving a negative Rinne.

The other options are different ear assessments that don’t use a tuning fork: tympanometry measures middle-ear pressure and movement of the eardrum, otoscope is for visually inspecting the ear canal and eardrum, and acoustic reflectometry analyzes how sound reflects off the tympanic membrane to infer middle-ear status.