Webber hearing test

[CCOMER]

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Why is hearing is lateralized to the side with conductive loss in Webber test? Does it have anything to do with with sound wave cancellation in healthy ears? Does anyone have a good explanation?

 

[TexasTriathlete]

The conduction problem blocks out external noise. No interference, so it lateralizes to the affected ear.

 

[danzman]

The conduction problem blocks out external noise. No interference, so it lateralizes to the affected ear.

Yup. The vibrations still reach the cochlea, just through the skull bones rather than the tympanic membrane etc.

 

[Igor4sugry]

The sound reaches the cochlea through both bone and the external ear. My guess is that in normal hearing the sound energy from the air and from the bone are slightly out of phase and so the overall effect is a dampened wave.

When there is a conductive hearing loss, it is only the sound energy form the bone that reaches the cochlea, so this dampening effect is not present and results in a larger stimulation of Organ of Corti on the conductive hearing loss side. So you end up hear a louder sound on that side.

 

[bigDinLV]

Hum and then plug and unplug your ears with your fingers. You'll see how it works.

 

[MikeMD]

air waves ("background noise") is heard more loudly by the inner ear hair cells in the cochlea compared to bone condution. If you have conductive hearing loss, this is not possible beacuse the sound cannot be transmitted via the tympanic membrane to the middle ear bones and then to the inner ear. Thus the sound will be louder in the ear with the conductive loss because it does not have the outside air/background noise obscuring the sound transmitted via bone.

hope this helps

 

[TexasTriathlete]

That's what I said, gunner.

 

[MikeMD]

That's what I said, gunner.

lol sorry dude i just got excited that I finally knew an answer to something, didn't even read the other posts

 

[TexasTriathlete]

Yeah yeah. Save it for your friends in the front row.

 

[marcrusc]

I was burning a little time and came across this Weber question. The theory about less ambient noise is logical, but the primary reason that the Weber lateralizes to the worse ear in unilateral conductive losses is due to the Occlusion Effect. In an unoccluded canal, low frequency components of sounds are able to roll naturally out of the canal. However, with an occluded canal, they are not able to do so. Low-frequency tones (such as the 512 Hz tuning fork) carry the volume of signals. If those low frequencies are not able to roll out, then the overall level of the signal is increased. By sticking your finger in your ear, you are containing those low frequencies. Therefore, it is not as much the lessening of ambient noise, but the raising of low frequency components. If there are any concerns about hearing, the wisest thing would be to refer to an Audiologist. Patient report is a much more sensitive tool than any Weber or Rinne ever wanted to be. These questions should be answered in a much more thorough, sophisticated manner than a set of tuning forks can provide.

 

[facetguy]

I was burning a little time and came across this Weber question. The theory about less ambient noise is logical, but the primary reason that the Weber lateralizes to the worse ear in unilateral conductive losses is due to the Occlusion Effect. In an unoccluded canal, low frequency components of sounds are able to roll naturally out of the canal. However, with an occluded canal, they are not able to do so. Low-frequency tones (such as the 512 Hz tuning fork) carry the volume of signals. If those low frequencies are not able to roll out, then the overall level of the signal is increased. By sticking your finger in your ear, you are containing those low frequencies. Therefore, it is not as much the lessening of ambient noise, but the raising of low frequency components. If there are any concerns about hearing, the wisest thing would be to refer to an Audiologist. Patient report is a much more sensitive tool than any Weber or Rinne ever wanted to be. These questions should be answered in a much more thorough, sophisticated manner than a set of tuning forks can provide.

Unless the patient has crappy insurance, in which case we're stuck with the tuning forks and yelling.

 

[marcrusc]

True enough! You've gotta love those insurance companies! It is my understanding though that as long as a physician diagnoses hearing loss, which can be reasonably done purely from patient report, most all insurances will cover a full diagnostic evaluation. I know that this is the case for the Medicare crowd. The unfortunate thing though is that more people have hearing loss in the 45-55 age range than in any other range. Does anybody have an idea of hearing evaluation coverage for major insurance providers?