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HUMAN EAR & SIMPLE TESTS OF HEARING Anatomy Types of Hearing Loss Conductive - Outer or Middle ear Lesion Sensorineural - Inner or Pathway Lesion Mixed - Simultaneous Conductive & Sensorineural Loss Pathways for Sound Tuning Fork Tests Purpose Types of Tests Schwabach Weber Rinne Bing Tuning Fork Tests Schwabach Procedure Assumption is that examiner has normal hearing 1. Examiner places TF on patient’s mastoid 2. Patient lets examiner know when they no longer hear tone. 3. Examiner places TF on their own mastoid Schwabach Interpertation If examiner hears longer you have a diminished schwabach which is consistent with a sensorineural loss. If patient hears tone longer you have a prolonged schwabach consistent with a conductive loss. Weber Procedure TF is placed on midline (forehead or vertex) of head. Patient is to indicate where they hear the TF the loudest. Interpretation If in the good ear = sensorineural If in the poor ear = conductive Rinne Procedure TF is alternately placed on mastoid and about 1 to 2 inches from pinna. Interpretation If heard better on mastoid = negative rinne = conductive loss. If heard better through air = positive rinne = sensorineural loss. Procedures Bing TF is placed on mastoid. Finger is used to alternately open and close the ear canal Interpretation If placing finger in ear canal makes sound louder = positive bing = sensorineural loss. If patient doesn’t notice a difference = negative bing = conductive loss Summary of Tuning Fork Tests Test Conductive Sensorineural Schwabach Prolonged Diminished Rinne - + Bing - + Weber Lateralize to BAD ear Lateralize to GOOD ear Summary