Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                
Scribd
Upload
2 views

tuning fork tests new

Tuning fork tests are auditory assessments used to evaluate hearing loss through air conduction (AC) and bone conduction (BC). The main tests include Rinne, Weber, Schwabach, and Bing tests, each serving specific purposes in diagnosing conductive and sensorineural hearing loss. These tests are quick and easy to administer but may present challenges such as false negatives and difficulties in interpretation.

Uploaded by

ASMAA NOORUDHEEN
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
2 views

tuning fork tests new

Tuning fork tests are auditory assessments used to evaluate hearing loss through air conduction (AC) and bone conduction (BC). The main tests include Rinne, Weber, Schwabach, and Bing tests, each serving specific purposes in diagnosing conductive and sensorineural hearing loss. These tests are quick and easy to administer but may present challenges such as false negatives and difficulties in interpretation.

Uploaded by

ASMAA NOORUDHEEN
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 8

TUNING FORK TESTS

A tuning fork is a metal instrument with a handle and two prongs or tines. Tuning
forks will vibrate at a set frequency to produce a musical tone when struck. The
vibrations produced can be used to assess a person’s ability to hear various sound
frequencies. A vibrating tuning fork held next to the ear or placed against the skull
will stimulate the inner ear to vibrate, and can help determine if there is hearing
loss.

Two basic tests can be done by tuning forks, air conduction and bone conduction.
AC measures ability of air-bone sound wave to be transmitted to the inner ear by
external ear canal. Ear drum and ossicular chain, AC testing is done by holding the
vibrating tuning fork near ear auditory canal. BC measures ability of inner ear and
the auditory nerve to receive and utilize sound stimuli. In BC test, external ear,
auditory canal, and middle ear areas are bypassed. The base or handle of the
vibrating tuning fork is held on the skull

A tuning fork should not be struck very hard; it should be struck on something
firm, but not hard. The knee, elbow and rubber are examples of firm surfaces.

Principle of Tuning Fork Tests


Conductive hearing loss; sounds delivered to the ear via AC will be attenuated. If
the sound is delivered to the ear via BC, bypassing the outer ear and middle ear,
then the sound will be heard normally assuming there is no disorder.
Types of Tuning Fork Tests
There are mainly two types of tuning fork tests:

1. Standard tuning fork tests


2. Audiometric tuning fork tests

Standard Tuning Fork Tests


1. Rinne Test
2. Weber Test
3. Schwabach Test
4. Bing Test

 RINNE TEST

Aim: To compare the hearing sensitivity by air conduction to that of hearing


sensitivity by bone conduction.

Principle:Based on the idea that hearing mechanism is more efficient by AC than


by BC.

Procedure
 The clinician set the tuning fork in to vibration by striking it on a firm surface
 Then the patient is asked to state whether the tuning fork sound is louder when
its base is placed on mastoid process or when it is placed near the ear opening.
Result
 The tuning fork test is positive when the tuning fork sounds louder at the ear
opening (positive rinne).This implies that patient is having normal hearing or
sensory neural hearing loss.
 Result is negative, when the tuning fork is louder when placed at the mastoid
(negative rinne).This implies that patient is having conductive hearing loss.

Advantages
 Easy to administer.
 Less time consuming.
 Quick invasive screening test.

Disadvantages
 False negative responses may occur.
 There is always chance of getting response to the tone by the non-test ear.
 Give rise to improper diagnosis of CHL.
 Will not get any degree of hearing loss.
 Cannot be tested on patients with tinnitus.
 Doesn’t control the quality and quantity of test.

 WEBER TEST

Aim: It is a test of lateralization


Principle: Weber effect is based on “stenger principle”.If two tones are identical
except they are different in loudness, are introduced simultaneously into both ears,
only the louder tone will be perceived.

Procedure
 The clinician set the tuning fork in to vibration by striking it on a firm surface.
 The stem of the tuning fork is placed on the forehead.
 The patient is asked to state where they hear the tone, whether it is a midline
sensation or at the poorer ear or at the better ear.

Result
 In case of normal hearing, the patient will have a midline sensation, that is the
will be heard equally loud from both ears.
 In case of conductive hearing loss, the tone lateralizes to the poorer ear.
 In case of sensory neural hearing loss, the tone lateralizes to the better ear.

Advantages
 Easy to administer.
 Less time consuming.
 Quick invasive screening test.

Disadvantages
 Difficult to interpret in cases of unilateral CHL and MHL.
 Tone should be presented at higher intensity.
 Will not get any degree of hearing loss.
 Cannot be tested on patients with tinnitus.
 Doesn’t control the quality and quantity of test.

 SCHWABACH TEST
Aim: It is a test for comparing hearing sensitivity of the patient to that of the
clinician (assuming that he or she has normal hearing).

Principle: The test has two principle characteristics:


 It makes use of the fact that the tone produced by a tuning fork becomes softer
with time after it has been struck due to damping.
 The patient’s hearing is expressed in relative terms compared with examiner’s
hearing ability.

Procedures
 The clinician set the tuning fork in to vibration by striking it on a firm surface.
 Then the base of the fork is placed alternately against the mastoid process of the
patient and the clinician.
 When the patient no longer hears the tone, the clinicians immediately places the
stem of the tuning fork on his or her mastoid and note the number of seconds
the tone is heard after the patient stops hearing.

Result
 Normal schwabach: the patient and clinician have normal hearing both will stop
hearing the tone at the same time.
 Patient has normal hearing.
 Diminished schwabach: if the patient has sensorineural hearing loss, the patient
will stop hearing the sound much sooner than the clinician.
 Patient has sensory neural hearing loss.
 Prolonged schwabach: if patient has conductive hearing loss, he hears for long
time than the clinician.
 Patient has conductive hearing loss.

Advantages
 Can differentiate between conductive and sensory neural hearing loss.
 Less time consuming.
 Quick invasive screening test

Disadvantages
 Difficulties in the administration and interpretation of test in cases of MHL.
 False negative responses may occur.
 There is always chance of getting response to the tone by the non-test ear.
 Give rise to improper diagnosis of CHL.
 If examiner has hearing loss, this test cannot be administered.

 BING TEST

Aim:Assesses the presence of conductive hearing loss.


Principle:It is based on “occlusion effect”.
Procedure
 The clinician set the tuning fork in to vibration by striking it on a firm surface.
 Tuning fork is placed on the patient’s mastoid, while the ear canal is
alternatively opened and closed by the examiner by depressing tragus and the
patient is asked to state which position is louder.

Result
 Positive Bing: When the ear canal is closed on a person with normal hearing or
SNHL, low frequency bone conducted signals are heard more loudly.
 Negative Bing: Patients with CHL will not experience this sensation and the
tone will be the same when the ear canal is open and closed and the test will be
a negative Bing because the ear already has a conductive impairment.

Advantages
 Easy to administer.
 Less time consuming.
 Quick invasive screening test.

Disadvantages
 False negative responses may occur.
 There is always chance of getting response to the tone by the non-test ear.
 Give rise to improper diagnosis of CHL.

Summary of tuning fork tests:


Test Purpose Fork Normal hearing Conductive SNHL
placement hearing loss
Schwabach Compare Mastoid Normal Normal or Diminished
patients BC process Schwabach: Prolonged Schwabach:
to normal Patient hears tone Schwabach: Patient hears tone
as long as examiner Patient hears tone for shorter time
as long as or than examiner
longer than
examiner
Rinne Compare Alternately Positive Negative Positive Rinne :
patient’s mastoid Rinne:Louder at the Rinne:Louder Louder at the ear
AC to BC process and ear behind the ear
opening to
ear canal
Bing Determine Mastoid Positive Bing: Tone Negative Positive
presence or process is louder with ear Bing:Loudness Bing:Tone is
absence of occluded does not change louder with ear
occlusion with ear occlude occluded
effect
Weber Check Midline of Tone equally loud Tone louder in Tone louder in
lateralizatio head in both ears poorer ear better ear
n of tone in
unilateral
losses
References:
1. Essentials of Audiology- Stanely.A.Gelfand
2. Introduction to Audiology- John Greer Clark, Fredrick.N.Martin.

You might also like