EARS / HEARING ASSESSEMENT

THE EAR
• THE EAR IS THE ORGAN OF HEARING AND, IN MAMMALS,
BALANCE.
THREE PARTS—
THE OUTER EAR,
THE MIDDLE EAR AND
THE INNER EAR.
THE OUTER EAR CONSISTS OF THE PINNA AND THE EAR
CANAL.
 EARS AND HEARING : INSPECTION

• EQUIPMENT
- TUNING FORK
- OTOSCOPE
 INSPECTION OF THE EARS
1. PINNA – EXAMINE FOR:
- SIZE
- SHAPE, POSITION
- COLOR
- LESIONS
- MASSES
2. EXTERNAL CANAL – WITH OTOSCOPE INSPECT FOR:
• DISCHARGE
• IMPACTED CERUMEN
• INFLAMMATION
• MASSES
• FOREIGN BODIES
- EXTERNAL CANAL IS NORMALLY CLEAR WITH MINIMAL
CERUMEN.
3. TYMPANIC MEMBRANE
• EXAMINE FOR :
• COLOR, LUSTER, SHAPE, POSITION
• TRANSPARENCY
• INTEGRITY
• SCARRING

• TYMPANIC MEMBRANE IS NORMALLY GREY IN COLOR AND

INTACT.
 INSPECTION OF THE EAR
• WITH OTOSCOPE
1. HOLD HELIX OF THE EAR AND GENTLY PULL THE PINNA
AND BACK TOWARD THE OCCIPUT TO STRAIGHTEN THE
EXTERNAL CANAL.
2. GENTLY INSERT THE LIGHTED OTOSCOPE.
3. PUT EYE UP TO THE EYEPIECE AND EXAMINE THE
EXTERNAL CANAL.
 PALPATION OF THE EAR

1. PINNA ( AURICLE )
• EXAMINE FOR TENDERNESS, CONSISTENCY OF THE
CARTILAGE, SWELLING.
• MOVE PINNA AND PUSH TRAGUS FOR TENDERNESS.
 MECHANICAL TESTS FOR HEARING

MECHANICAL TESTS FOR HEARING

1. WHISPER VOICE TESTS
2. TUNING FORK TESTS
- WEBER
- RINNE
 WHISPER VOICE TEST
• STAND AT THE SIDE OF THE PATIENT, AWAY FROM THE EAR
BEING TESTED
• COVER EAR NOT BEING TESTED
• WHISPER 2- SYLLABLE WORDS
• PATIENT CAN HEAR
WHISPERED WORDS.
 WEBER TEST

• TEST FOR LATERALIZATION OF VIBRATION

• PLACE ROUNDED TIP OF HANDLE OF THE VIBRATING TUNING
FORK IN THE MIDDLE OF THE SCALP, NEAR THE FOREHEAD.
• NORMALLY, SOUND IS HEARD IN THE CENTER OF THE HEAD OR
EQUALLY ON BOTH EARS.
 RINNE TEST
• COMPARES AIR AND BONE CONDUCTION
• PLACE VIBRATING TUNING FORK ON THE MASTOID PROCESS
BEHIND THE EAR AND HAVE PATIENT TELL WHEN VIBRATION STOPS.
• QUICKLY HOLD THE VIBRATING END OF THE TUNING FORK NEAR
THE OPENING OF THE EAR CANAL( 2 INCHES AWAY) AND ASK IF
PATIENT CAN HEAR .
• NORMALLY, SOUND IS HEARD AFTER VIBRATION CAN NO LONGER
FELT, AIR CONDUCTION IS BETTER TAN BONE CONDUCTION.
RINNE TEST
 ABNORMAL FINDINGS
1. OTALGIA - EARACHE
2. OTORRHEA – EAR DISCHARGE
3. PRESBYCUSSIS – HEARING LOSS DUE TO OLD AGE
4. TINNITUS – RINGING IN THE EARS
5. VERTIGO – FEELS AS IF ROOM SPINS.
6. MICROTIA- SMALL EARS , LESS THAN 4CM VERTICALLY
 ABNORMAL FINDINGS

7. MACROTIA – LARGE EARS, LARGER THAN 10CM

VERTICALLY.
8. IMPACTED CERUMEN
9. OTITIS MEDIA – INFECTION OF THE MIDDLE EAR
10. OTITIS EXTERNA