HEARING TESTS, HEARING TESTS, AUDIOMETRY, AUDIOMETRY,

TYMPANOMETRY, AND TYMPANOMETRY, AND VESTIBULAR FUNCTION VESTIBULAR FUNCTION

TESTS.TESTS.

AUDIOLOGYAUDIOLOGY► It is the study of science of hearing and It is the study of science of hearing and

includes all aspects of,includes all aspects of,► AcousticsAcoustics► Physiology of hearingPhysiology of hearing►Disorders of hearingDisorders of hearing► Functional examination & assessment of Functional examination & assessment of

hearinghearing► Education & rehabilitation of deaf (including Education & rehabilitation of deaf (including

hearing aid & cochlear implant)hearing aid & cochlear implant)

Audiology helps,Audiology helps,►To assess the degree of hearing lossTo assess the degree of hearing loss►The type of hearing lossThe type of hearing loss►The site of the lesion producing the The site of the lesion producing the

hearing losshearing loss►The impact of the hearing loss on The impact of the hearing loss on

speech developmentspeech development►To provide the guide lines about the To provide the guide lines about the

plan of rehabilitation of deafplan of rehabilitation of deaf

Functional Examination of Functional Examination of hearing (Hearing Assessment)hearing (Hearing Assessment)

►Clinical testsClinical tests►Audiometric testsAudiometric tests

Clinical testsClinical testsVoice & whisper testVoice & whisper test

Tuning fork testsTuning fork tests

Audiometry:Audiometry:Subjective audiometrySubjective audiometry

1)1) Pure tone audiometryPure tone audiometry2)2) Bekesy audiometryBekesy audiometry3)3) Speech audiometrySpeech audiometry

Objective audiometryObjective audiometryA.A. Impedance audiometryImpedance audiometry1)1) TympanometryTympanometry2)2) Intraaural reflex measurementIntraaural reflex measurementB. Evoked Response AudiometryB. Evoked Response Audiometry1)1) Electrocochelography Electrocochelography 2)2) Brainstem ERA (BER)Brainstem ERA (BER)3)3) Cortical ERACortical ERA4)4) Post auricular myogenic responsesPost auricular myogenic responses

Clinical Tests For HearingClinical Tests For Hearing1.1. Voice and whisper testVoice and whisper test2.2. Tuning fork tests.Tuning fork tests.

Tuning Fork Test.Tuning Fork Test.A.A. Rinne’s testRinne’s testB.B. Weber testWeber testC.C. ABC testABC test

Available tuning forksAvailable tuning forks►128 Hz128 Hz►256 Hz256 Hz►512 Hz512 Hz►1024 Hz1024 Hz►2048 Hz2048 Hz►4096 Hz4096 Hz

RINNE’S TEST:RINNE’S TEST:Principle: Essentially it compares (the auditory Principle: Essentially it compares (the auditory

acuity) of air conduction with the bone acuity) of air conduction with the bone conduction of an ear.conduction of an ear.

Procedure: ………………………………........Procedure: ………………………………........Interpretation:Interpretation:1.AC>BC1.AC>BC (R+) (R+) Normal hearingNormal hearing2.AC>BC2.AC>BC (R+) (R+) SNH lossSNH loss3.AC<BC3.AC<BC (R-) (R-) Conductive hearing lossConductive hearing loss4.AC----Not heard----But BC is heard----(False R-)4.AC----Not heard----But BC is heard----(False R-)(the opposite ear has to be masked to confirm (the opposite ear has to be masked to confirm

or otherwise D E)or otherwise D E)

Tuning ForksTuning Forks R-veR-ve Approximate Approximate hearing losshearing loss

128Hz128Hz R-veR-ve >10dB>10dB256Hz256Hz R-veR-ve >15dB>15dB512Hz512Hz R-veR-ve >20dB>20dB1024Hz1024Hz R-veR-ve >25dB>25dB2048Hz2048Hz R-veR-ve >30dB>30dB4096Hz4096Hz R-veR-ve >35dB>35dB

WEBER TEST:WEBER TEST:Principle: Compares the hearing loss in the two earsPrinciple: Compares the hearing loss in the two earsProcedure:…………………………………Procedure:…………………………………Interpretation:Interpretation: NormalNormal1)1) Midline,Midline, Bilat symmetrical lossBilat symmetrical loss2)2) Head, genrallyHead, genrally3)3) Equally in both earsEqually in both ears

Lateralized to (R)Lateralized to (R) = R conductive hearing loss= R conductive hearing lossOROR

= (L) SN Hearing loss= (L) SN Hearing loss

ABC TEST:ABC TEST:Principle: Compares the bone conduction Principle: Compares the bone conduction

of the patient with that of the examiner, of the patient with that of the examiner, the latter being taken as normal.the latter being taken as normal.

Procedure: ……………………………………..Procedure: ……………………………………..Interpretation:Interpretation:1.1. In Normal person AND Conductive In Normal person AND Conductive

deafness the ABC is normal.deafness the ABC is normal.2.2. In Sensorineural hearing loss the ABC is In Sensorineural hearing loss the ABC is

AUDIOMETRY:AUDIOMETRY:Audiometry is the measurement of the Audiometry is the measurement of the

hearing loss with electronic device, hearing loss with electronic device, AUDIOMETERAUDIOMETER

PURE TONE (Subjective) Audiometry: Only PURE TONE (Subjective) Audiometry: Only this type of Audiometry can show that this type of Audiometry can show that the entire system is working.the entire system is working.

AUDIGRAM: It is defined as the qualitative AUDIGRAM: It is defined as the qualitative and quantitative graphic presentation of and quantitative graphic presentation of a hearing acuity of a person.a hearing acuity of a person.