The Massachusetts General Hospital Handbook of Neurology

Authors: Flaherty, Alice W.; Rost, Natalia S.

Title: Massachusetts General Hospital Handbook of Neurology, The, 2nd Edition

Copyright 2007 Lippincott Williams & Wilkins

> Table of Contents > Adult Neurology > Hearing

Hearing

A. Weber's test

Tuning fork on vertex.

• 1. Conductive (middle ear) deafness: Fork is louder in affected ear.

• 2. Perceptive (inner ear) deafness: Fork is louder in good ear.

B. Rinne's test

Tuning fork on mastoid first; when no longer heard, hold it in air by ear.

• 1. Normal: Air conduction heard twice as long as bone conduction.

• 2. Conductive deafness: Air conduction briefer than bone conduction.

• 3. Perceptive deafness: Test is normal (air conduction heard longer).

C. Causes of deafness

• 1. Middle ear: Wax, foreign body, trauma, infection, otosclerosis.

• 2. Cochlea: M ni re's dz, inflammation, trauma, tumor, toxin (aminoglycoside, cisplatin), vasculitis, internal auditory artery occlusion.

• 3. Retrocochlear: Cerebellopontine angle mass (acoustic Schwannoma, meningioma, aneurysm, dermoid, epidermoid), multiple sclerosis, brainstem glioma, syringobulbia, inflammation (zoster), brainstem infarct (especially AICA).