Hearing test using a tuning fork

One of the most effective and accessible ways to differentially diagnose ear problems is to study hearing with tuning forks. It is often prescribed to identify conductive and perceptual hearing loss.
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Indications for tuning fork examination

Research using multi-frequency tuning forks allows us to determine the nature and type of hearing damage. During the examination, the doctor uses special medical tuning forks. With their help, hearing sensitivity is assessed and sound conduction through the air and bone structures of the patient is analyzed.

People who work in noisy environments or frequently attend loud events also need a hearing test. In addition, people who have a history of hearing loss in their family should be examined.

A tuning fork is used in the following cases:

  • If you suspect hearing loss The first sign that your hearing is deteriorating is difficulty understanding speech. In this case, the person has to constantly ask again and increase the volume of the TV.
  • After injury It is imperative to see a doctor after severe blows to the head resulting from a fall or accident.
  • With age-related changes With age, hearing abilities deteriorate. A tuning fork study helps determine the level of these changes.

Indicators and research

Verified indicators

Each indicator being checked has its own range of values. More detailed information about this is presented in the table.

Indicator

Description

Unit

Possible indicators

Sound conduction through air

Evaluation of the hearing aid's ability to perceive sounds transmitted through the air.

Decibels (dB)

Normal: 0-25 dB; Reduced: 26-40 dB; Moderate reduction: 41-55 dB; Heavy reduction: >55 dB

Sound conduction through bone

It checks how well the skull bone conducts sounds. This helps rule out or confirm the presence of problems in the middle ear.

Decibels (dB)

Normal: 0-25 dB; Reduced: 26-40 dB; Moderate reduction: 41-55 dB; Heavy reduction: >55 dB

Balance between ears

Comparison of the hearing function of both ears. Sometimes hearing problems are observed only on one side. This is usually due to injury or an infection that affects only one ear.

Without one

Symmetrical; Asymmetric

Response to different sound frequencies

It is intended to study the ability to perceive high, medium and low frequencies.

Hertz (Hz)

Low: 250-500 Hz; Mid: 1000-2000 Hz; Treble: 4000-8000 Hz

Hearing threshold

It is intended to determine the minimum volume at which the ear is able to detect sound.

Decibels (dB)

Audibility: ≤25 dB; Reduced audibility: 26-40 dB; Hearing loss: >40 dB

Air conduction hearing testing

During a tuning fork hearing test, the doctor lightly hits the device. At the same time, the tuning fork makes a vibrating sound. The specialist then places the device at some distance from the patient's ear. In this way, the doctor tests the patient’s ability to perceive and distinguish sounds at different volume levels and tones. The patient's task is to report whether he hears the sound. He should also tell the doctor when hearing becomes worse.

In this way, a tuning fork test helps determine how well the outer and middle ears are working. If the patient does not hear sound, this indicates a blockage in the ear canal or a problem with the eardrum.

Bone conduction hearing test

Bone conduction testing tests how effectively the bones of the skull transmit sound waves directly to the inner ear. To do this, the doctor activates the instrument and applies it to the mastoid - a bony protrusion located directly behind the auricle.

The patient must be told whether he hears the sound. This test allows your doctor to determine how well your inner ear and auditory nerve are functioning. If the test results show that bone conduction is better than air conduction, this indicates the development of otitis media or perforation (perforation) of the eardrum.

General information

How is a hearing test performed using a tuning fork

A standard tuning fork is a metal instrument with two teeth. When struck, it produces a sound that has a clearly defined frequency. Therefore, its use allows an accurate analysis of the patient's hearing ability.

Stages of conducting a tonal study:

  1. Selecting a tool. The doctor selects the device that is best suited for tuning fork hearing testing. Typically its frequency varies from 128 to 512 Hz. Low frequencies are best used to assess bone conduction, high frequencies for air conduction.
  2. Device activation. The clinic specialist adjusts it using a soft rubber stick. When testing your hearing, it is important that the device sounds clear, without vibrations or extraneous noise.
  3. Tuning fork study of air conductivity. The doctor brings a sounding tuning fork to the patient's outer ear canal at a distance of several centimeters. The patient must inform the clinic specialist about any changes in hearing.
  4. Tuning fork bone conduction study. After completing the air conduction test, the doctor applies the still sounding device to the mastoid. The patient must again report whether he hears the sound.
  5. Comparison of results. The doctor compares the duration of audibility of sound by air and bone. It is considered normal if air conduction lasts longer than bone conduction. Otherwise, there is a possibility of problems in the middle ear.

Upon completion of a tuning fork hearing test, the doctor analyzes the data obtained and makes preliminary conclusions about the condition of the patient’s ears. After this, if necessary, the clinic specialist will refer the patient for additional examination. Then treatment is prescribed.

Preparing for testing

A tuning fork hearing test is carried out in a quiet room with a minimum level of extraneous noise. First, the doctor performs a visual examination of the patient's ears using an otoscope. This allows him to ensure that the ear canals are free of wax, inflammation or other abnormalities that could affect the test results.

Then the clinic specialist selects a suitable device, checks it for serviceability and advises the patient on what and how he should react during testing. In particular, during a hearing test, the doctor usually asks the patient to cover the free ear with his hand or a special plug.

To get a consultation

Methods of hearing research

There are three main methods for studying hearing using a tuning fork: Weber's experiment, Rinne's experiment and Jelle's experiment.

  1. Weber's experiment is used to determine the symmetry of hearing and identify the difference between the right and left ear.

    Before the hearing test, the specialist activates the tuning fork. He then places the base of the device against the center of the patient's head, usually the forehead or crown of the head. During the hearing test, the patient must indicate which ear he hears sound better - the right, left, or both equally well. If the sound is heard equally in both ears, this indicates symmetrical hearing. Otherwise, we are talking about a violation of sound conduction in a particular ear or sensorineural hearing loss.

  2. Rinne's research compares the conduction of sound through bones and through air. This helps determine the type of hearing loss.

    This study allows you to clarify the presence of problems with both ears. In the process, the doctor activates a tuning fork and places it on the mastoid process behind the patient's ear. After the patient reports a decrease in hearing, the doctor moves the tuning fork closer to the outer ear. This allows air conductivity to be checked. If the sound is heard longer in the air than through the bones, this is considered a normal result, confirming that there are no conduction problems (a positive Rinne test result). Otherwise, we are talking about the presence of conductive hearing loss (negative Rinne test result).

  3. Jelle's experiment is used to diagnose otosclerosis, a disease in which abnormal bone growth blocks sound waves.

    This method of examining hearing using a tuning fork is used when otosclerosis is suspected. The examination in the hospital begins with the activation of the device. After this, the specialist applies its base to the mastoid process. Then, using a pneumatic ear specula, the doctor changes the pressure in the ear canal. The patient should inform the doctor about any changes. If the perception remains unchanged during pressure fluctuations, this indicates the development of otosclerosis. Changes in the perception of sound with pressure fluctuations are considered a normal result.

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Sadikov
Ilya Sergeyevich
Head of the Clinic for Otorhinolaryngology, Otorhinolaryngologist
Tetzoeva
Zalina Muratovna
Head of the department of otorhinolaryngology, otorhinolaryngologist
Lapshina
Anastasia Andreevna
Otolaryngologist, audiologist
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Andrew Stanislavovich
Chief Specialist in Otorhinolaryngology
Portnyagina
Maria Pavlovna
Audiologist-otorhinolaryngologist
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Galina Rustemovna
Otorhinolaryngologist, otoneurologist, audiologist
Budeikina
Liliya Sergeevna
Otorhinolaryngologist, phoniatrist
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