Physical examination on Hearing Loss

A simple hearing challenge may confirm hearing loss or detect significant hearing asymmetry. Ask the patient to cover one ear and try to detect soft sounds such as the tick of a watch, the scratching of two fingers rubbed together, or a softly whispered voice. Inspect the canal and TM to rule out the obvious causes of CHL. Cerumen impaction is a remarkably common and easily corrected cause of hearing loss. Pneumatoscopy to check for the normal movement of the TM helps rule out perforation, atelectasis, eustachian tube dysfunction, stiffened TM, ossicular disruption, and middle ear effusion.