A ticking watch is moved away from the patient's ear until the sound is no longer audible. The test is repeated bilaterally, and norms are established for the patient. Findings should be the same for the clinician with normal hearing. Document normal or abnormal responses.
Testing Procedures -
Air and Bone Conduction
Place the base of an activated tuning fork on the patient's mastoid process until the patient no longer hears the sound, then move the vibrating portion of the tuning fork by the patient's ear. Note the presence or absence of the patient's ability to hear the tuning fork, and also note the patient’s ability to hear the sound as long as the therapist. The test is then performed on the other side. The measurement for air-conducted sound should be twice that of bone-conducted sound. Document normal or abnormal responses.
Testing Procedures - Lateralization
Place the base of an activated tuning fork on the ventral-cranial aspect of the patient's head. Determine if the sound is centralized or referred (i.e., lateralized) to one side. The sound should
remain centralized. Document normal or abnormal responses.
Special Instructions or Considerations
- Patients with decreased or absent air-bone conduction will hear the vibration louder on the affected side
- Patients with sensory neural deficits will present with lateralization to the unaffected side
- The patient could hum if a tuning fork is not available
