Simple tests of hearing

Bone conduction and air conduction

outer ear and the middle ear

inner ear and auditory nerve

the inner ear and auditory nerve

outer ear is ok middle ear not ok bone conduction is normal, air conduction not ok

outer and middle ear are ok. air conduction and bone conduction impaired.  Inner ear damage

conductive and sensorineural impairments. Middle and inner ear damage

less mass, higher stiffness, gives higher pitch and vibrates faster

compares patient hearing to examiners hearing

tuning fork on mastoid, examiner closes and opens the ear canal with finger. Pulsating sound= positive bing, no change in loudness=negative bing(conductive loss)

when the ear canal is occluded bone conduction becomes louder.  If there is conductive hearing loss this affect is absent

• compares patients hearing by bone and by air, Air is louder than bone normally.  If this is not the case then there must be some sort of occlusion.
• Procedure: hold fork on bone then on outside of ear. alternate back and forth

• test of lateralization: if hearing is normal and fork is placed on forehead you wont be able to tell which ear is stronger. 
• -when there is sensorineural loss the sound will be louder (lateralize) to the better ear.
• -when there is conductive loss the sound will lateralize to the side of loss.