Assessing Hearing: Sensorineural Vs Conductive Hearing Loss - Weber And Rinne Test - Dr Gill
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- เผยแพร่เมื่อ 20 พ.ค. 2024
- Hearing Assessment - Sensorineural vs Conductive Hearing Loss - Webers and Rinnes Test - Dr Gill
One of the easier parts of the cranial nerve examination to performed is looking at cranial nerve VIII - the vestibular cochlear system. If a patient comments, or is found to have hearing loss, then we need to determine if that is conductive hearing loss, or sensorineural hearing loss.
We perform a hearing assessment in this case by performing two linked tests - Webers and Rinnes test. These two tests allow us to determine if there is hearing loss from a sensorineural issue, for example menieres disease, age related hearing loss, or a tumour. They also allow testing for a conductive hearing loss, which is most commonly observed in ear wax
It is crucial that the 512hz tuning fork is used for this part of the cranial nerves test, as the 128hz tuning fork should be reserved for testing vibration sensation.
Please note there will always be minor variations in how clinical examinations are performed. You should priorities the input from your educators or institutions in terms of directions used
Some people may find an ASMR effect from these clinical examination videos.
There are two linked videos with this examination:
Cranial nerve examination demonstration - • Cranial Nerve Examinat...
Cranial Nerve VIII - The Vestibulocochlear Nerve
• Cranial Nerve VIII - T...
#CranialNerves #ClinicalSkills #DrGill
You can now consult via video or in person with Dr Gill at Dr Finlay’s Private Practice - www.drfinlays.co.uk/services/...
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Dr. Gill is like the Bob Ross of medicine.
😂
I've been saying for a decade Bob Ross is the ASMR OG
@@pinebarrenpatriot8289 so has everyone else? Do you want a diploma?
@@Hejhejhej2233 just get your vaccine like the dummy you are and move on. 😅
Init
"We're not looking for adequate here. We're looking for excellence." Excellent.
Very true. Medicine is about the best care we can manage, and actively choosing a middle ground where we have the ability to reasonably choose the best… isnt really acceptable 😊
Doc had that one fuckin loaded in the barrel
Excellence is all Dr Gill will accept.
It’s the only thing fair for the patient
dr gill, i will probably become a nurse this fall on my way to becoming a med student, and your videos keep me going as i finish school, had my first exam today, actually! please know the educational and inspirational value of your videos does not go unnoticed and continously motivate me to go towards what i want the most … thank you for everything you do
Great message, good luck with the exams
what was your grade?
Good luck with everything you need to do to make your goals a reality!
That’s wonderful to hear! I hope things are going well - which country are you training in?
Yay - Abbie and Dr Gill! Looking forward to it!
A special favour after a revision session from
Abbie
These videos are heading in a great direction. Not a student or professional in the field, just a guy in his 30s more mindful about his health. Thank you!
the aim is to help the students, but I’m glad it’s helping others too 😊
@@DrJamesGill I am aware of this, you may recall my previous comments about pictures and diagrams presented not long enough for me to understand. This time the balance was perfect even for an untrained intellectual.. at least that's how I like to think about myself.
This doctor is quite a catch. I love his soothing voice, his accent, the way he dresses, his deep blue eyes, everything about him.
He had us at "crisps"
I stumbled upon your videos a while ago and was an art student at the time.
A year later I’m now a med student and I can not be more grateful for your videos for not only teaching me but also having a part in inspiring me to change my career choice.
Welcome to the club Sarah - Where are you studying?
@@DrJamesGill Sarah you better reply
Reply plsss
Reply reply reply
Sarah stop playing games
My youngest son was born hard of hearing. (Bilateral hearing aids since 3 months old). He has a mixed hearing loss (more sensory loss than conductive). Thank you for explaining the difference.
I’m sorry to hear about your son. However I’m aware that the technology for hearing impaired individuals has improved TREMENDOUSLY in the last decade
How old is your son if you don’t mind me asking?
Really good graphics and the approach of giving the information. Such a wonderful doc and a patient :) Love it. Thanks for your work!
🤣🤣 actually I think there is a law stopping owning of human genes
I’m a big fan of the words on screen having a background behind them :) makes them much easier to read! Wonderful and informative video as always. Thanks Dr. Gill, have a great weekend!
Thank you. I’m still learning and changing things, but this seems to have worked 😊
@@DrJamesGill it’s an excellent change! I love these videos
For unintentional ASMR, I liked the older videos more. I always get the most tingles when Dr. Gill is examining something and thinking out loud to what he is doing. Or gives very calm instructions.
Outstanding presentation as usual, Doctor, and great to see Abbie as always. Best to each of you!
Fascinating as always, thank you for your hard work on these videos Dr. Gill
The best thing about Dr. Gill is that I relax and learn something new at the same time
Abby and dr Gill the best team.
👏👏👏👏👏👏👏
I just want to say that I watch these videos because: the ASMR factor, and for practicing my English listening
Thank you Dr Gill!! I learn so much about medicine and clinical stuff too
These two are quickly gaining legendary status
Thanks again! An idea for future videos is that it could be good to do a quick debrief from the patients perspective. I.e. you could ask Abby "how was that for you?", "was bone or air conduction louder for you?", "was the bone conduction unpleasant?" (perhaps you could talk about a scenario where it might be). Also I remember as a child having a hearing test with beeps via headphones, might have been a nice way to have some viewer participation. Keep up the great work!
Con todo el respeto doc que voz tan relajante ustedes tiene .
Gracias por dar conocimiento.
This is fun for me to watch as a hearing impaired person looking to go into audiology.
That is an excellent career option, you’ll be able to give a real insight to your patients journey
@@DrJamesGill yeah part of why is due to my own curiosity in the subject, while the other is hoping I can make others have a better experience than I did.
@@noah2418 WHAT?!
@@zachz699 what?
@@noah2418 I need you to speak up
Was looking for asmr but found this and still learned some cool things. The blockage like earwax that can cause things to sound louder while being plugged cause of the bones in your ear makes so much sense as to why when that happens I can like hear my head functions more like blood flow, pulse, etc.
It’s also why we can hear our heart beat clearly when we lie in the Bath with our ears under water 😊
Wonderful information and presentation!
Yes...we're here for the clinical skills...
Interesting video. My ENT said that I had lost my hearing in my left ear due to a virus (this was ten years ago, so not COVID). It mostly came back after a course of steroids, but one night it was like somebody unplugged a stereo speaker, the room started spinning and it never came back. After a few years, I was examined by an audiologist and was told that I have a big scar on my eardrum. Hearing aid doesn’t do much other than amplify indecipherable noise. Oh well, maybe they’ll come up with something one day.
😥
ASMR community aside, Dr. Gill provides excellent educational videos. Really appreciate his videos. I feel asleep before we got to the test, however. The tingles were too much
Tutty and The Gillster are always appreciated.
I don't know why you're so relaxing but you are.
Thanks a bunch doc ❤✌
I love the matching smirks they gave when asking Abbie's DOB 😂
Same! I was about to comment the same thing and wanted to check if anyone else mentioned it :)
Dr Gill, your voice is heavenly. If it wasn't for you riveting lectures which I'm sure your tutees love, I wouldn't be surprised if your students fell asleep because of your euphonious voice.
I think I just bore the majority of them !
Particularly nice vest in this video, looks warm.
yey my fav dynamic duo of physical exam world back at it again
Nice as always, educational content and asmr. The best. Greetings from Italy 🇮🇹.
Hope it’s useful
I’m glad he’s established that.
This was fascinating! Excellent video! I would love to learn more about the kidneys and electrolytes if you ever make a video on that!
We will likely look at some of the physiology in the future 😊
I'm no doctor or nurse but I just love how the information is provided and presented by Dr Gill such amazing person thank you
I’m grateful you find it accessible! 😊 thank you
Audiogram with hearing loss on left. Weber lateralizes to the left ear, but AC>BC. Conductive because of the audiogram and localization, or Mixed because of Rinne AC>BC component?
Abby's back yay! 🙃
Very well explained.
Thanks. I found this one tough at med school!
Good video. Although I would stress that vestibular schwannomas are rare and the most common type of sensori-neural hearing loss is with age and general wear and tear to the cochlear's hair cells.
Absolutely
yay another abby video 😁 hope shes doing well 😊
I have auditory processing disorder so my brain hears everything equally and doesn’t distinguish background noises from relevant noises making it harder for me to process relevant noises such as someone trying to speak to me because I’m simultaneously listening to all of the other noises around me such as a ticking clock, running furnace, passing car, radio or television on in the background etc. but I was also born with ears that didn’t internally form properly which frequently causes them to build up with wax blocking some of my hearing if I’m not careful so I’ve always found this topic rather interesting.
Because of the information overload I sometimes have trouble with my speech as a result and words in my brain don’t always make it back out to my mouth properly because they get stuck in a traffic jam along the way which is very frustrating. Ironically using sign language completely bypasses the issue for me because it’s a visual language but not enough people know it for me to communicate with it effectively. Fascinating stuff!!!
Great video and interesting information.
Glad you think so!
What is seen in the Weber test of a subject suffering from neural hearing loss in the right ear
only?
1) will hear the sound better in the right ear
2) will hear the sound in the center of the head
3) will hear the sound weaker in the right ear
4) will hear the sound better when we attach the speaker to the mastoid
Abbie always has a smile in her eyes. So cute.
Dr. Gill could you do a explanation on phoropters
I have to get an eye exam every couple years and would like to know how they actually work
Abbie!! ❤ I wonder if she has any idea how many fans she has.
Everything that I know about medicine is for you Dr Gill
👍
I wondered why this video suddenly got recommended to me. After a minute I realized that this could be used as ASMR because my god is that a beautiful voice
“Or, heck!” made me smile 😊
He really is
So basically, lets say a patient hears the Weber's test better in the left ear, they either have a sensorineural hearing loss in the right ear or a conductive hearing loss in the left one, right?
And to verify this we need to use Rinne's test to see if the Bone Conduction for the left ear is better than its Air conduction: if BC > AC, it's a conductive hearing loss in the left ear, if it is not, most likely the AC in the right ear will be less effective than the BC which will show a sensorineural hearing loss in the right ear.
Did I get this right? I'm not a medical student but as a student in audio engineering everything about sound is fascinating to me
Thank you so much for the videos, I subscribed for more :) you never know when you might switch careers lol
Perfect 😊
:D Dear doctor, your voice is wonderful.
ok fine I'll do it... Any double vision?
AAAAAdequate! Love it!
Another amazing video very informative
Thanks. I think the new format is working - what do you think?
@@DrJamesGill i think it's working very well helps medical students learn and understand Medical terminology and health conditions keep it up
I love these videos :) the human body is an incredible machine
Honestly, I was palpating a vein today - and honestly after I’d finished with the patient I thought EXACTLY the same.
We are amazing, and there are SO many analogies to machines. I almost feel down a Battlestar Galatica hole for a moment
OrCHEStra
Love it.
I had no need to watch this but very informational and relaxing nice job
Gaining info and knowledge it always a good use of time. There are many channels I watch on here just for that 😊
What will be the result of Weber's test for bilateral snhl?
Dr Gill I vibrate at 250 all the time.
Tô usando de asmr pq ele fala muito bem👌
Educational n relaxing 😌
👍
I thought the framing was strange, but Dr.'s shirt camouflaged against the wall :D
Thank you for the video, informative as always.
Hearing loss runs in my paternal family line and I need to have my hearing regularly checked. They use the headphone bleep method.
audiometry like that is really useful for looking at changes in ability to hear tones - as it can potentially pick up things before the patient is aware
In my opinion we don’t do enough screening medicine, to try to catch things early
Amazing…!!!
👍
does the sticker of asrm slogan good for my bike Doctor.?
Really enjoyed this video, love having the diagrams and graphics on screen!👍
Ahhhh relaxing and informative. Sleepy eyes and beddy byes
So good as always! Hi Abby! Soz Doc you lost me about halfway through, it got a bit too scientific and technical for me! I'm not so good at Dr Techno stuff! Doh!
Plus you are so softly spoken, which is nice, but I thought I was suffering a hearing loss at first and had to increase my volume! Lol
Greetings from Uruguay doc!!!
Thanks for explaining as you go along, I've always wondered why doctors do certain things that don't necessarily seem obvious at first.
I’m hoping this new way of doing the examinations is helpful 😊
@@DrJamesGill It most certainly is Dr. Gill. I hope to see more of these sort of videos in the future. All the best!
Good video Dr Gill. I have hearing loss in my left ear due to use of a shotgun for years. First noticed it when lying in bed on my good ear. When I lived my head I could then hear a house alarm going off down the road. Put my good ear back on the pillow and the sound was gone. Bit depressing initially. I went for a hearing test and was fully expecting to need a hearing aid but the guy said I only I had only a narrow frequency of hearing loss and a hearing aid wouldn't help. Interesting. Still pretty deaf in my left ear though.
I’m the same on my right. It’s depressing as hell
@@jodyjackson5475 ah dont worry about it man. I did too for a while and then you get used to it. If your other ear is in good nic you will be grand. I do put an ear plug in that ear when i go shooting now though.
The irony of this video having extremely low audio.
Yes, unfortunately the audio is one area I suck at editing
Had to rewind, got hung up on how nice the repeating letters in 'Ototoxicity' looks... ototo, ototo, ototo, ototo... great, now I have to rewind again.
I have sensorineural hearing loss in my right ear and have lived with tinnitus for almost 10 years now. Thankfully, my hearing is mostly normal except for a certain range in my right ear (and the constant ringing). I'm sure my wife would beg to differ, though. 🤣
i’m sorry for you, how do you deal with the tinnitus
Well, the easiest thing to do was to just keep on living my life. If you let it drive you mad, it will. Gladly, I can still enjoy music and everything since my hearing is mostly intact. The goal now is to preserve what I have.
I had tinnitus when I flew with a congested nose and my ear drum ruptured. It was driving me crazy until I started using white noise. Especially to sleep. I hope this helps if you haven't figured it out yet.
Been using white noise and ASMR for years. Small children also make me tired enough to sleep without being bothered by the noise. 🤪
Update: I will be undergoing a septoplasty and sinuplasty in June. My ENT doc didn't have much to say about the tinnitus, but he's pretty firm that it's time to finally correct my deviated septum as trying to remedy my recent ear issues with medication (and visits to an allergist) haven't been successful.
The irony of this video being hard to hear (in the best way) is delicious
This video was a good one. Structured, clear, use of camera position, using a 3D-model and the best: practical demonstration. Keep up the good work!
Did you get media training? Haha.
Warm regards from the Netherlands
Glad you enjoyed it! I’ve just been trying to improved my fcp knowledge mainky
This is really interesting. I struggle with my hearing but whenever I go for a test I'm told it's fine, although I need subtitles on the tv and if I hear two sounds at once I can't hear either well 🤔 Not sure what's going on.
Ok, so I think the first thing that would need to be established is WHAT is the hearing issue, and then carry on from there
Have you actually had hearing test where they have you listening to various tone?
I learn alot when I come here to relax lol thats the best kind of learning
Learning is power 😊
Why is it that bone conduction hearing aids involve drilling a hole in the persons head and hooking what looks like one of those anti-theft tags you see in clothes shops on to the back of their head, when there are bone conductive headphones available on the market that also work against conductive hearing loss, but for some reason they are only marketed as for leisure?
"We're not looking for adequate here, we're looking for excellence." I love that!!!!!
It’s true. When treating our patients we should aspire to the best care we can
We have to acknowledge that might not always be possible, but we have to try 😊
I had one of these when I was in my early 20s but I didn't realise it had a name! They found that my hearing was normal but I was experiencing a lot of physical blockages because my sinuses are about .0000000734 nanometers in width and I get snot backed up in the system constantly. Now I'm in my 50s but I'm still not using my nasal spray. Metallica overcomes most barriers :D
Abbie... repping the 7th Dec crew 🤜🤛
i hope they use these videos with student doctors
I got hearing loss because my step parents yelled at me so much when I was a kid.
sup! dr. , how are you doin?
Weber and Rinne's test, eh? The 2012 Nashville Predators must've been the best hearing hockey team of all time.
Hey doctor how do you call it if you hear voices that are confirmed the same as what people speak ...
I’m sorry I don’t quite follow the question
I have heard that they should be able to hear in air conduction twice as long as bone conduction. Is that true? BTW, I am not a medical professional of any sort, just enjoy learning.
I’ve not heard that specifically. But think that it might not be accurate as there are so many variables
@@DrJamesGill Thank you!
Wish my pillow was as soft as Dr Gills voice
So, I heard recently that there is such a thing as psychosomatic blindness, and now I'm wondering, is there psychosomatic deafness? And would there be a way to test it?
I think as you say that would be difficult to test
I have sensorial hearing loss in both ears , starting wearing hearing aids 5 years ago. The Audiologist told me that i was most like born with the hearing loss. Would love to know what the life span of well looked after hearing aids are?
I’m honestly not sure. I think I recall it is something like 5-10yrs.
But that may be a affected by make and model
@@DrJamesGill thanks
can use in profound sensorineural hearing loss
Yes, as it would still allow us to confirm that problem
Could you also ask them what sounds louder when doing Rinne’s test?
Not really. As you only move from the mastoid when that sound has disappeared
How to regenerate hair cells??i have sensorineural deafness
Unfortunately I don’t think it’s possible yet. Re growth of nerves effectively is one of our medical dreams
@@DrJamesGill but there are not early treatments??? I had seen that there were possibilities by injection
I've lost the hearing in my right ear due to a vestibular schwannoma. I had cyber knife radiation treatment, rather than surgery, as there was a better chance my hearing would survive. Sadly it didn't. Not been for a year, though. But thank you for this, or has encouraged me to goand just get an aid.
My word! That’s quite a story! I’m sorry it wasn’t entirely successful. I’ve had similar patients, and the surgery has also lead to issues with the facial nerve, so perhaps the radiation was the right option?
@@DrJamesGill That was the recommendation, indeed. The cyber knife was remarkable: 3 days, 3 half-hour sessions. No ill effects - apart from the eventual hearing loss. The tumour shrunk from 29mm to 21 mm between February 2020 (the treatment), and August 2020 when I had an MRI. Was due one in August 2021 too but never transpired; busy with Covid, I imagine.
I broke my temporal bone and with tuning fork test it looks like I have conductive hearng loss and tinnitus, I'm going for another hearing test on Tuesday and need an MRI scan just worried what the problem might be
Oh dear. I’m sorry to hear about your accident.
If would be really interesting to hear back after for your result if you’d be able to tell us?
@@DrJamesGill I can, I'm really scared though, is conductive hearing loss usually fixable in some way, I would like some measure of hearing back in this ear, at least to drown out the tinitus
Obviously I’m not able and allowed to give specific advice, but I can say it all depends on what the cause is.
On the simplest example, conductive hearing loss due to wax, will be resolved when the wax has been addressed.
@@DrJamesGill I doubt it's wax since I've only had this from since breaking my temporal bone in accident
Absolutely. I was using that an an example of conductive hearing loss improving with resolution of the issue
I feel like i’ve just stumbled upon a rare thing because of how early i am.. it’s 1pm sounds right for a nap
This video was amazing, and just in the perfect timing. The last month I’ve been diagnosed with Otoesclerosis and Menieres Disease, Dr. Gill. So this is the first time that i can actually personally relate to one of the topics being discussed in the video. I’m a big fan, keep the good job!!🤍🤍🦻🦻
Gosh that’s quite a diagnosis. What are they doing for you at the moment?
@@DrJamesGill I’m gonna be following a treatment of taking pills and doing nasal puffs. Also I am now using a hearing aid. It’s hard since I’m only 22, but i trynna keep being positive 🤍