Hearing Tests

  • Rinne’s Test

    rinne test

Definition

Rinne’s test is a hearing test that compares the perception of sounds as it compares the patient’s ability to hear a tone conducted via air and bone through the mastoid process. It should always be accompanied by a Weber’s test that is used to detect a sensorineural hearing loss, confirming the nature of hearing problem.

Purpose

To evaluate a patient’s hearing ability by air conduction compared to that of bone conduction.

Equipment: Tuning fork

Procedure

  1. Explain the procedure to the patient to promote cooperation.
  2. Sit the patient in a chair comfortably.
  3. Strike a 512 Hz tuning fork softly (knees or elbows slightly not the table) otherwise the vibrations will be excessive and cause the patient discomfort.
  4. Place the vibrating tuning fork on the base of the mastoid bone. Hold the fork for 2-3 seconds to allow sufficient time to make a mental note of the stimulus intensity.
  5. Ask the client to tell you when the sound is no longer heard.
  6. After the sound is no longer appreciated the vibrating top is held one inch from the external auditory meatus.
  7. The patient is asked whether the sound is louder behind or in front – referring to bone and air conduction respectively.

Interpretation of Results

Normal: A patient with normal hearing will hear the tone of the vibration longer and louder when the tuning fork is held next to the ear than that against the mastoid bone.

Positive Hearing Loss or “Reversed Rinne”: When a patient hears a louder and longer tone when the vibrating tuning fork is held against the mastoid bone than when it is held next to the ear.

  • Weber’s Test

Definition

Weber’s test is a quick hearing test that is performed with Rinne’s test.

Purpose

The Weber test is used to determine a patient’s hearing ability by bone conduction and is useful in detecting a unilateral (one-sided or asymmetrical) conductive hearing loss and unilateral sensorineural hearing loss.

Equipment: Tuning Fork

Procedure

  1. Explain the procedure to the patient to promote cooperation.
  2. Sit the patient in a chair comfortably.
  3. Strike a 512 Hz tuning fork softly (knees or elbows slightly not the table) otherwise the vibrations will be excessive and cause the patient discomfort.
  4. Place the vibrating tuning fork on the middle of the patient’s head. Hold the fork for 2-3 seconds to allow sufficient time to make a mental note of the stimulus intensity.
  5. Ask client if the sound is heard better in one ear or the same in both ears.

Interpretation of Results

Normal Response: sound is heard equally at both ears.

Sensorineural Hearing Loss: loudest sound in unaffected ear. This is because the affected ear is less effective at picking up sound even if it is transmitted directly by conduction into the inner ear.

Conductive Hearing Loss: Loudest sound in affected ear (hears vibrations only). This is because the conduction problem masks the ambient noise of the room, whilst the well-functioning inner ear picks the sound up via the bones of the skull causing it to be perceived as a louder sound than in the unaffected ear.

Watch a video on rinne and weber’s test courtesy of  Youtube.com

http://www.youtube.com/watch?v=FNy7dgOwu30

images from drdavidson.ucsd.edu, drdavidson.ucsd.edu

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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