Compares air conduction with bone conduction (sensitivity 60-90%, specificity 95-98%).
Strike 512 Hz tuning fork then place firmly on mastoid process (bone conduction)
When pitch no longer audible, place fork parallel to patient’s ear (air conduction)
Negative: AC > BC indicates normal function or sensorineural hearing loss
Positive: BC > AC indicates conductive loss in that ear
Doyle PJ, Anderson D W, Pijl S. The tuning fork: an essential instrument in otologic practice. Journal of Otolaryngology. 1984;13(2): 83-86