Now I'm going to demonstrate
the advanced ENT testing. If you have a patient
with hearing loss, there are two tests that you can perform for this patient. First is the Rinee test. What you do is you tap
on your tuning fork, put it behind the patient's
ear on this bony prominence, just be behind the ear and you ask the patient. Can
you hear the sound here? Yes. And tell me when it stops. Now. And can you hear it there? Yes. All right. So that's normal for Steve
to be able to hear sound through the air more or longer than he can
hear sound through bone. If bone conduction is
greater than air conduction, in other words, if he can hear the sound through the bone, and then I bring it to his
ear and he can't hear it, then that would be a sign that he has conductive hearing loss. That means that there's
something blocking the sound coming from the
outside of the canal, getting to the
tympanic membrane, either ear wax or perhaps some scarring or some abnormality of
the ear drum itself. If he had hearing
loss in this ear and bone conduction is less
than air conduction, meaning he can hear the sound in front here longer than
he can hear it in the back, that would go along with
sensory neural hearing loss, a problem with the nerve that's leading from the ear
back to the brain. Now, the second test
is the Weber test, and using the tuning fork again, you place it up on the
patient's forehead or on top of his head. And you ask, Steve, do you hear this in both ears? Yes. All right. And that's
normal to be able to hear the sound in both ears. If his right side had hearing loss and he can hear the sound better
in the right ear, that goes along with
conductive hearing loss, scarring of the tympanic
membrane, or ear wax. If he hears the sound
better in the good ear, if the left ear is the good ear, that then indicates a
sensory neural hearing loss. That concludes the
advanced testing of the ears with the Weber
and the Rinee test.