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Our Gardiner Brown medical tuning forks are designed for the accurate diagnosis of hearing loss, diabetic neuropathy & other conditions. Sound is a pressure wave and is the result of molecules impacting upon each other, caused for example by objects hitting each other (such as a hammer onto an anvil) or from objects vibrating (such as our vocal chords).
Many decades ago hearing tests were carried out on several hundred young adults with anatomically healthy ears by measuring the faintest level of puretone signal each could hear, measured in dBSPL. Note 2: As shown in the graph above, young adults with healthy ears can typically hear between 20Hz (very low pitch) to 20,000Hz (very high pitch), but as we grow older this range narrows, especially from the high frequency end.
It would be quite confusing to use a graph like this to base every other test upon, so a flat graph called an Audiogram was produced (shown below).
A typical test result is shown below, on an Audiogram which also shows where typical speech sounds occur. This audiogram shows a client with good low frequency hearing and mild to moderate high frequency hearing loss.
The circle on the left shows that the client is hearing louder vowels sounds normally, but the circle on the right shows they are missing the quieter consonant sounds, which are needed for clarity of speech. A cholesteatoma is a skin growth that occurs in an abnormal location, the middle ear behind the eardrum.
Cholesteatoma is a serious but treatable ear condition which can only be diagnosed by medical examination. Otitis media is the inflammation of the middle ear and occurs most commonly during the winter and early spring months.
Remember, without proper treatment, damage from an ear infection can cause chronic or permanent hearing loss.
Earwax is healthy in normal amounts and serves to coat the skin of the ear canal where it acts as a temporary water repellent. Most of the time the ear canals are self-cleaning; that is, there is a slow and orderly migration of ear canal skin from the eardrum to the ear opening. When cerumen is removed from the ear, the physician uses sucion, a cerumen spoon, or delicate forceps to do so.
A perforated eardrum is a hole or rupture in the eardrum, a thin membrane that separates the ear canal and the middle ear. Middle ear infections may cause pain, hearing loss, and spontaneous rupture (tear) of the ear-drum resulting in a perforation. On rare occasions a small hole may remain in the eardrum after a previously placed PE tube (pressure equalizing) either falls out or is removed by the physician. Most eardrum perforations heal spontaneously within weeks after rupture, although some may take up to several months. The most common symptoms of swimmer’s ear are mild to moderate pain that is aggravated by tugging on the auricle and an itchy ear. WARNING: If you already have an ear infection, or if you have ever had a perforated or otherwise injured eardrum, or ear surgery, you should consult an ear, nose, and throat specialist before you go swimming and before you use any type of ear drops. The tympanogram is a test that measures how easily the eardrum vibrates back and forth and and what pressure the vibration is the easiest. The ABR is a special hearing test that can be used to track the nerve signals arising in the inner ear as they travel through the hearing nerve (called the auditory nerve) to the region of the brain responsible for hearing.
The ABR can also be used on small infants since it requires no conscious response from the person being tested. The ENG (short for electronystagmogram) is actually not a hearing test but rather a special test of the balance mechanism of the inner ear. The way to a hearing aid fitting often begins with a feeling that your hearing is not as it should be or that your hearing has worsened. A hearing care professional determines with the help of a hearing test whether or not a hearing loss is present.
From here on, the assumption is that you have a sensorineural hearing loss (that you have nerve damage to the inner ear).
If you have a standard audiogram, highlight the 20 dB line that crosses the graph from left to right.
If all of the X's (for the left ear) and all of the 0's (for the right ear) fall above the line you just drew, you have normal hearing. Your hearing loss is classified according to how far down the graph the marks go, and in what freqencies the loss occurs. Some other common variations include putting the left and right ears on different graphs, and using a different interval for the frequencies across the top. Early signs of an acoustic neuroma include single-sided sensorineural hearing loss (or double-sided in neurofibromatosis type II), tinnitus (sound in the ear, often a high-pitched ringing or a roaring sound), problems with balance (either vertigo or an off-balance feeling) and feelings of fullness in the ear(s) affected. As the tumour slowly increases in size, it may begin to affect other cranial nerves (usually the V and the VII).


Acoustic neuromas cause hearing impairment because they grow on the eighth cranial nerve, also called the vestibulocochlear (hearing and balance) nerve. These red flags will prompt the clinician to refer to an ear, nose, and throat specialist (ENT), who will use scans such as an MRI or CT to diagnose an acoustic neuroma. It is thought that acoustic neuromas arise because of a defect in a gene that typically prevents tumours from growing. If the tumour grows large enough, an ENT may opt for one of two other treatments: radiation or surgery. In order to improve our understanding of acoustic neuromas, researchers are currently looking into causes of acoustic neuromas and improvements in surgical techniques. We have 3 locations in Calgary: North, North West and South and an office in each Okotoks, Cranbrook and Creston, and Invermere, British Columbia.
The middle ear consists of three small bones called the "ossicles": malleus (hammer), incus (anvil) and stapes (stirrup). But did you know that tuning forks could al In order to determine what kind of hearing loss is present, a bone conduction hearing test is administered. Sound therefore requires a molecular medium to pass through, and the sound is heard until the energy fades out (this fade through air is halved every doubling of distance and is known as the inverse square law). This then gave an average minimum threshold of hearing for people with good hearing in which to measure other people against.
Hearing tests are typically limited between 250Hz-8000Hz being that this is the range of speech. This client will therefore perceive that people are not speaking clearly – a clear sign of early stage hearing loss. These funnel through the ear opening, down the ear, canal, and strike your eardrum, causing it to vibrate. It is usually due to repeated infection, which causes an ingrowth of the skin of the eardrum.
Persisting earache, ear drainage, ear pressure, hearing loss, dizziness, or facial muscle weakness signals the need for evaluation by an otolaryngologist-head and neck surgeon.
Old earwax is constantly being transported from the ear canal to the ear opening where it usually dries, flakes, and falls out.
However, if you want to clean your ears, you can wash the external ear with a cloth over a finger, but do not insert anything into the ear canal. It typically occurs in swimmers, but the since the cause of the infection is water trapped in the ear canal, bathing or showering may also cause this common infection.
If you do not know if you have or ever had a perforated, punctured, ruptured, or otherwise injured eardrum, ask your ear doctor. This graph shows the amount of hearing loss expressed in units called decibels at different sound frequencies (also called Hertz).
The middle ear is normally filled with air at a pressure equal to the surrounding atmosphere. A special probe is placed up against the ear canal, like an ear plug, and the equipment automatically makes the measurements. The test is useful because it can tell us where along that path the hearing loss has occurred.
The test involves running a cool liquid and then a warm liquid through the ear canal (it is usually done through a small tube so the ear itself remains dry). This feeling may originate from situations where you have to ask for sentences to be repeated or when other people complain that the television is too loud while you regard it as comfortable.
This may produce symptoms like facial weakness and loss of sensation in the face on the affected side. A growth on this nerve prevents the sound from travelling efficiently from the inner ear to the auditory processing centres of the brain, causing sensorineural hearing loss.
These red flags include, asymmetrical hearing loss, poor word understanding, and absent reflexes on the affected side.
This involves check-ups to monitor symptoms, repeated imaging studies, and the use of hearing aids if appropriate. Genetic studies are being conducted in attempts to isolate the specific gene(s) associated with acoustic neuromas and the reasons they may become defective. For example: the Elephant (17 - 10,000 Hz), the Monkey (110 - 45,000 Hz), the Mouse (1,000 - 90,000 Mhz), the Bat (3,000 - 120,000 Hz).
Invented in 1711 by John Shore, tuning forks were created to establish the pitch of various musical instruments. The graph also shows the average upper threshold of hearing where sounds are considered uncomfortable (but not painful) – which is on average 120dBHL. The vibrations are passed to the small bones of the middle ear, which transmit them to the hearing nerve in the inner ear.


Cholesteatomas often take the form of a cyst or pouch that sheds layers of old skin that builds up inside the ear. The middle ear is connected to the nose by the eustachian tube, which equalizes pressure in the middle ear. When water is trapped in the ear canal, bacteria that normally inhabit the skin and ear canal multiply, causing infection and irritation of the ear canal. Simple tests, such as ones done in many schools, may be useful for screening, but a careful audiogram is necessary for accurate diagnosis of most hearing problems. If the middle ear is filled with fluid, the eardrum will not vibrate properly and the tympanogram will be flat.
For example, the ABR is often used for individuals with a sensorineural (nerve) loss in just one ear. Special electrodes automatically record the nerve signal; the patient can even be asleep during the test. This change in temperature stimulates the inner ear which in turn causes rapid reflex movements of the eyes. Making a serious mistake, family pressure, or safety concerns are also reasons people often cite for seeking a hearing solution.
In the case where a hearing loss is present, the kind and degree of your hearing loss is determined individually for each ear and entered in an audiogram. This is a more correct term, as the tumour affects the vestibular portion of the eighth nerve.
As mentioned earlier, acoustic neuromas are also sometimes associated with neurofibromatosis type II. Surgery is dependent on the person’s age, medical condition, and the size of the tumour.
Surgical techniques are also being investigated in order to minimize damage to surrounding nerves when removing tumours. Here, the vibrations become nerve impulses and go directly to the brain, which interprets the impulses as sound (music, voice, a car horn, etc.). Over time, the cholesteatoma can increase in size and destroy the surrounding delicate bones of the middle ear. If the middle ear is filled with air but at a higher or lower pressure than the surrounding atmosphere, the tympanogram will be shifted in its position. This movements are recorded, and from these we can get information about how well this balance mechanism is functioning. Occasionally, these tumours will affect both the left and the right eighth nerves through a disorder called neurofibromatosis type II.
Because these tumours are so slow-growing, people typically do not begin experiencing symptoms until after the age of thirty. Because the tumour grows on the vestibulocochlear nerve, a person will often have no measurable hearing post-surgery. Hearing loss, dizziness, and facial muscle paralysis are rare but can result from continued cholesteatoma growth. If the ABR is normal along that region of the path, the chances of having this tumor are quite small.
However, this is very rare, and symptoms of this disorder will typically be present by the time a person reaches age 21. Balance problems may also be present following surgery, but these balance issues usually improve quickly because of compensation from the vestibular system of the unaffected side. The fifth and seventh cranial nerves can be at risk during surgery as well, leaving a chance of facial weakness or numbness following the surgery.
In the Rinne test, a comparison is made between hearing elicited by placing the base of a tuning fork applied to the mastoid area (bone), and then after the sound is no. Hearing Tests - Boulder Behavioral Health Network of Care - Community-based resources and tools for individuals, families and agencies concerned with mental health. On occasion the doctor may hold the tuning fork against the bone at the rear of the ear, called the mastoid, to test hearing when sound vibrations are directed to the inner ear. These heavy duty Gardiner Brown medical tuning forks are ideal for Rinne-Weber tests and diagnosing diabetic neuropathy, facial nerve trauma & temporal bone fractures.
But did you know that tuning forks could al Invented in 1711 by John Shore, tuning forks were created to establish the pitch of various musical instruments.



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