Otolaryngol Head Neck Surg 2018 Aug 159:220.The purpose of this study was to determine strength and flexibility of the spinal and hamstring muscles among University of Ibadan students and the reliability of Kraus-Weber (K-W) exercise test. Diagnostic accuracy of tuning fork tests for hearing loss: a systematic review. Hearing impairment and cognitive decline: a pilot study conducted within the atherosclerosis risk in communities neurocognitive study. Otolaryngol Head Neck Surg 2008 Oct 3 139:S1.ĭeal JA et al. Clinical practice guideline: cerumen impaction. Diagnosing otitis media-otoscopy and cerumen removal. Serous otitis media in the left ear (fluid in the middle ear) results in a conductive hearing loss and also lateralizes the Weber test to the left. Otosclerosis in the left ear is a cause of conductive hearing loss and causes the Weber test to lateralize to the left. Presbycusis greater in the right ear is functionally similar to sensorineural hearing loss on the right, and again the Weber test would lateralize to the left. Cerumen should be removed with a curette, cerumenolytics, lavage, or a combination of these methods.Ī right-sided vestibular schwannoma results in a sensorineural hearing loss on the right side, so the Weber test would lateralize to the left. Loss of hearing leads to a decrease in interaction with others, greater isolation, and cognitive decline. This may result in decreased cognitive function in vulnerable populations. Substantial impaction can lead to conductive hearing loss from impaired mechanical transmission of sound. Of the answer options provided, the only one that leads to a Weber test lateralizing to the right ear is a conductive hearing loss from cerumen in the right ear.Ĭerumen impaction is common, particularly in nursing-home residents, older adults, patients with mental disabilities, and those who use hearing aids. In this patient, the Weber test lateralizes to the right ear, which could be consistent with either conductive hearing loss on the right or sensorineural hearing loss on the left. Most cases of wax obstruction give a mild conductive loss and do not cause the Rinne test to change to negative. When the conductive hearing loss is moderate (about 30 db or greater), the Rinne test changes to negative, and the Weber still lateralizes to the side of the conductive loss. When the conductive hearing loss is mild (less than about 30 db), the Rinne test remains positive and the Weber lateralizes to the side with conductive loss. In the Weber test, the tuning fork is placed in the middle of the skull, and the patient determines on which side the sounds can be heard most clearly. In conductive hearing loss, bone conduction is better than air conduction, and the sound is therefore heard better with the tuning fork on the mastoid process this is known as a negative Rinne test. In a normal ear, air conduction is better than bone conduction, and the patient can therefore hear the sound again when the tuning fork is moved from the mastoid process (bone) to outside the ear (air) this is known as a positive Rinne test. The fork is then immediately placed just outside the ear. The Rinne test is performed by placing a vibrating tuning fork on the mastoid process until sound is no longer heard. The most likely cause of conductive hearing loss in a nursing-home resident with debris in the ear is cerumen impaction. Key Learning Point View Case Presentation Learning Resources and Clinical Tools for Pain Management and Opioids.State Requirements for Pain Management CME.Pain Management and Opioids CME & Disclosures.Physician Remediation and Continuing Professional Development.
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