5Rinne TestObjective: This test is done to assess possible conduction deafness by comparing bone and air conduction.
6Obtain a tuning fork and strike it with a rubber hammer, causing it to vibrate Place the end of the fork’s handle against your partner’s mastoid process behind their ear. Have the prongs of the fork pointed downward and away from the ear (make sure nothing is touching them).The sound sensation is that of BONE CONDUCTION.Ask your partner to indicate when the sound is no longer heardThen QUICKLY, remove the fork from the mastoid process and position it in the air close to the opening of the nearby external acoustic meatus (ear canal).The sound sensation is that of AIR CONDUCTIONRECORD RESULTS (normal or impaired)
8Weber TestObjective: This test is used to distinguish possible conduction or sensory deafness.
9Strike the tuning fork with the rubber hammer Place the HANDLE of the fork against the midline (middle) of your partner’s foreheadAsk your partner to indicate if the sound is louder in one ear than in the other ear OR if it is equally loud in both earsRECORD results
11Weber Test ExtensionHave your partner experience the effects of conductive impairment by packing one ear with cotton and repeating the Weber test.Usually sound appears louder in the plugged (or impaired) ear because extraneous sound from the room are blocked out
13Rinne Test ResultsIf hearing is normal, the sound from AIR CONDUCTION will be heard again.Normal: Sound is heard through bone AND air conduction (+ Rinne Test)Conductive impairment: Sound is not heard after tuning fork is removed from the mastoid bone- only heard through bone because this sound bypasses the auricle, external acoustic meatus, and middle ear ( -Rinne Test)If no sensation is experienced, there is conductive impairment . Conductive impairment involves outer or middle ear defects. Hearing aids can improve hearing for conductive deafness because bone conduction transmits the sound into the inner ear. Surgery could possible correct this type of defectSensorineural impairment: Can hear the sound through air and bone conduction but sound is diminished. Probably heard longer and louder when on the mastoid process (+ Rinne Test )
14Weber Test ResultsIf hearing is normal, the sound should be heard equally in both earsConductive impairment: Sound will be LOUDER in AFFECTED ear. Conduction problems mask the noise in the room while the bone picks up sound via the skullSensorineural impairment: If some degree of sensory (nerve) deafness exists, sound will be LOUDER in NORMAL ear. This is because the bone is less effective at picking up sound even if it is transmitted directly into the inner ear.If you heard the sound in the Rinne test when the tuning fork was by your ear, you probably have this type of impairmentThe impairment involved the organ of Corti or the cochlear nerve. Hearing aids WILL NOT improve sensory deafnessCould be caused by loud noises (such as music) with no ear protection (Think Roger from our Hearing Case Study: No More Loud Music)