A 22-year-old man complains of hearing problems. You perform an examination of his auditory system including Rinne's and Weber's test:


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A 22-year-old man complains of hearing problems. You perform an examination of his auditory system including Rinne’s and Weber’s test:

Rinne’s test: Left ear: bone conduction > air conduction
Right ear: air conduction > bone conduction
Weber’s test: Lateralises to the left side

What do these tests imply?

Normal hearing
Left conductive deafness
Right conductive deafness
Left sensorineural deafness
Right sensorineural deafness

Dr. Kasper:
Left conductive deafness

Rinne’s and Weber’s test

Performing both Rinne’s and Weber’s test allows differentiation of conductive and sensorineural deafness.

Rinne’s test

tuning fork is placed over the mastoid process until the sound is no longer heard, followed by repositioning just over external acoustic meatus
air conduction (AC) is normally better than bone conduction (BC)
if BC > AC then conductive deafness

Weber’s test

tuning fork is placed in the middle of the forehead equidistant from the patient’s ears
the patient is then asked which side is loudest
in unilateral sensorineural deafness, sound is localised to the unaffected side
in unilateral conductive deafness, sound is localised to the affected side