The Rinne test compares the perception of sound waves transmitted by air conduction vs bone conduction and serves as a rapid screen for conductive hearing loss. If the patient has sensorineural hearing loss in the right ear, the tuning fork would only be heard in the left ear. So, for instance, if a patient has a perforation in the right tympanic membrane causing conductive hearing loss in the right hear, the tuning fork would be heard in both ears. The tuning fork will be heard in both ears in conductive hearing loss but will only be heard in the unaffected hear if sensorineural hearing loss is present. In a normal Weber test, the patient should hear the vibration of the tuning fork equally in both ears. The Weber test (ideally using a 512-Hz tuning fork) can detect either conductive or sensorineural hearing loss.

1-3 Weber and Rinne tests are essential when evaluating patients for unilateral hearing loss and determining the type of loss (ie, sensorineural vs conductive). The most common symptoms of sudden sensorineural hearing loss include not only acute hearing loss, but also tinnitus and fullness in the affected ear.ĭiagnosis.The initial evaluation should include an otoscopic examination, tuning fork tests, and pure tone audiometry. However, 90% of cases of SSNHL are considered idiopathic because the etiology cannot be determined. Bilateral SSNHL can be seen in autoimmune diseases and rarely can be caused by medications, such as aminoglycosides or certain chemotherapy medications.

Identifiable causes of SSNHL include viral infections, vascular events, cochlear hydrops, head trauma, tumors (eg, vestibular schwannoma), and demyelinating disorders. The annual incidence of SSNHL is 5 to 20 cases per 100,000 individuals worldwide. The typical age of onset is in the fourth and fifth decades, occurring with equal distribution in both sexes. 1 The majority of cases of SSNHL are unilateral. SSNHL is defined by hearing loss of more than 30 dB in at least 3 consecutive frequencies with acute onset of less than 72 hours. 1,2 The most common symptoms include acute hearing loss, tinnitus, and fullness in the affected ear. The positive Rinne test was consistent with a diagnosis of idiopathic sudden sensorineural hearing loss (SSNHL). Additionally, the normal tympanogram made conductive hearing loss from a middle ear effusion or tympanic membrane perforation unlikely. The Weber test confirmed the hearing loss was sensorineural and not conductive, ruling out a middle ear effusion. Pure tone audiometry showed severe sensorineural hearing loss in the left ear and a poor speech discrimination score. Tympanometry and otoscopic examination showed the bilateral tympanic membranes were normal. A Rinne test showed air conduction was louder than bone conduction in the affected left ear-a normal finding. A Weber test performed using a 512-Hz tuning fork lateralized to the right ear. The patient was afebrile on physical examination with a heart rate of 48 beats/min and blood pressure of 117/68 mm Hg. He denied any history of otologic surgery, trauma, or vision problems, and he was not taking any medications. He had noticed signs of a possible upper respiratory infection, including a sore throat and headache, the day before his symptoms started. He denied any vertigo, nausea, vomiting, otalgia, or otorrhea. 2015 19:358-360.Ī healthy 48-year-old man presented to our otolaryngology clinic with a 2-hour history of hearing loss, tinnitus, and fullness in the left ear. Steroid-induced osteonecrosis in dermatology: a review. Treatment of idiopathic sudden sensorineural hearing loss with antiviral therapy: a prospective, randomized, double-blind clinical trial. Westerlaken BO, Stokroos RJ, Dhooge IJ, et al. Clinical practice guideline: sudden hearing loss. Stachler RJ, Chandrasekhar SS, Archer SM, et al. Is intratympanic dexamethasone injection effective for the treatment of idiopathic sudden sensorineural hearing loss? J Audiol Otol. Oral vs intratympanic corticosteroid therapy for idiopathic sudden sensorineural hearing loss: a randomized trial. Rauch SD, Halpin CF, Antonelli PJ, et al. Treatment of sudden sensorineural hearing loss: II.

Steroids for idiopathic sudden sensorineural hearing loss. The efficacy of steroids in the treatment of idiopathic sudden hearing loss.

Magnetic resonance imaging findings in sudden sensorineural hearing loss. Magnetic resonance imaging findings in the auditory pathway of patients with sudden deafness. Idiopathic sudden sensorineural hearing loss. Schreiber BE, Agrup C, Haskard DO, et al.

Tuning fork hearing test