see also:

• sensorineural hearing loss / deafness
• ears, nose and throat surgery (ENT)
• ED Mx of vertigo and BPV
• tinnitus
• RVEEH clinical practice guidelines:
  • Idiopathic Sudden Sensorineural Hearing Loss (pdf)
  • Impacted Wax (pdf)

• deafness is classified as either conductive or sensorineural hearing loss / deafness or mixed and these are generally differentiated at the bedside by using Rinne and Weber tuning fork tests:
  • Rinne test:
    • place tuning fork on the mastoid bone behind the ear (tests bone conduction (BC)).
    • when the patient indicates sound is no longer heard, move fork (held at base) beside ear and ask if now audible.
    • in a normal test, AC > BC; patient can hear fork at ear.
    • in conductive loss, BC > AC; patient will not hear fork at ear
  • Weber test:
    • tuning fork is placed in middle of forehead
    • normal person should hear it equally in both ears
    • hearing it best in one ear implies either:
      • conductive loss in THAT ear, or,
      • sensorineural loss in the OPPOSITE ear
• in addition, hearing loss may be due to a central cause such as from a stroke (CVA) or present as auditory dyssynchrony (auditory neuropathy or auditory neuropathy spectrum disorder)

• wax
• foreign body
• otitis externa
• blood from trauma
• exostosis (eg. surfers in cold waters)
• psoriasis
• osteoma
• squamous cell carcinoma
• congenital microtia or atresia

• otitis media
• perforated tympanic membrane
• cholesteatoma
• otosclerosis
• temporal bone trauma
• glomus tumors
• surgery
• congenital atresia or ossicular chain malformation