I attended my doctor because I felt my hearing was not as good as it used to be. While I was there, he carried out some tests using a tuning fork and placing it at various points on my head. Can you tell me why he did this?
Although it may seem a little odd, using a tuning fork is a quick and valuable tool for assessing hearing loss and obtaining preliminary information about its cause.
There are three basic tuning fork tests, known as the Weber, the Rinne and the Schwabach tests.
These help determine whether a person perceives the tone of the tuning fork in one or both ears, compares bone and air conduction of sound in the ear, and compares the patient's bone conduction with that of the examiner - assuming the examiner has normal hearing.
During the assessment, the tuning fork is struck on a firm surface and the base of the vibrating fork placed on the person's forehead - the Weber test. For the Rinne test, the tuning fork is placed on the bone behind the ears, while for the Schwabach the doctor places the vibrating fork on the bone behind one of your ears and asks you to detect a tone. He then alternates the fork between his own and the patient's ear, until one of them stops hearing the tone.
How can a doctor tell from the tuning fork if there is a hearing problem?
A person with normal hearing will respond to the Weber test by hearing the same tone equally loud in both ears. In the Rinne test, the air-conducted tone should be louder than the bone-conducted tone, and in the case of a normal Schwabach test the tone should be detectable for the same duration as the tester.
I have been referred for another type of test called an audiogram. What will that involve?
An audiogram is a test that helps determine the presence and degree of hearing loss. It gives a record of the thresholds (the softest sound) at which a person can hear a set of test tones. For the audiogram, you will be fitted with headphones and seated in a soundproof test area. You will then hear tones and will be asked to signal when you hear the sound. The examination takes approximately 20 minutes and the results, in conjunction with the tuning fork test, will help your doctor diagnose the type and extent of your hearing problem.