assess whether the patient hears better by air or bone conduction. For this test, tap the tuning fork on the hand to activate it, and then place the base of the tuning fork on the patient’s mastoid bone. If the vibration is conducted through the bone, the patient hears a humming sound, time this interval of bone conduction, noting the number of seconds when the sound is no longer heard (as reported by the patient) move the still vibrating folk near the auricle ear canal (1-2cm) and ask the patient to tell you when the sound is no longer heard while continuing timing the seconds. Compare the number to seconds sound is heard by bine conduction versus air conduction, normally air conduction should be heard twice as long as bone conduction.
