13.15 CN VIII: Vestibulocochlear Nerves

Testing can begin with the client sitting on the exam table. Before testing the vestibulocochlear nerves, ask the client about any history of impaired hearing and use of hearing devices. If the client has a hearing aid, they should keep it on.

• General ability: Begin by noting the client’s general ability to hear you throughout your ongoing assessment process. For example, have you noticed any difficulties in hearing as manifested by leaning forward, lip reading, or consistently asking you to repeat what you say?
• Whisper voice test: this test also helps evaluate the cochlear nerve. Tell the client that you are going to whisper a mixture of three numbers and letters and you want them to repeat what you say. Ask them to look straight forward, place their index finger on the tragus of the right ear, push the tragus in, and move their finger over the tragus in a circular motion until you ask the client to stop. Stand on their left side (slightly behind them and about an arm’s length away) to test the left ear. Take a breath in, and as you breathe out, whisper a mixture of three numbers/letters (e.g., 8, E, 4). The client should repeat what you say. If they don’t, whisper another set of three numbers/letters (e.g., 2, K, 10). Repeat on the opposite ear with a different set of numbers/letters. See Video 12.
  • Normal findings are when the client can repeat what you say with both ears. If you need to repeat the set of numbers/letters on one ear (for a total of six), a normal finding is if the client is able to repeat at least half of the numbers/letters.
  • Abnormal findings are when the client is unable to repeat the set of numbers/letters on one or both ears or unable to repeat at least half of them if repeated twice.

Video 12: Whisper voice test.

• Note the findings.
  • Normal findings might be documented as: “Cochlear nerve test: With whispered voice test, client able to hear and repeat numbers and letters in both ears.”
  • Abnormal findings might be documented as: “Client unable to hear and repeat numbers and letters whispered in left ear.”