![]() ![]() “I’m going to put this vibrating tuning fork in two positions, one touching the bone near you ear, one a short distance from the ear.Rinne’s test can only detect a conductive hearing loss of at least 30dB.Rinne’s test has a high sensitivity (0.84) though this varies with the skill of the examiner.This test aims compare air conduction with bone conduction.Interpretation of Rinne’s and Weber’s tests Test The various outcomes of Rinne and Weber tests are shown below.In bilateral and symmetrical hearing loss of either type Weber’s test will be normal.If a patient has a unilateral sensorineural hearing loss, the tuning fork sound will be heard louder in the normal ear.If a patient has a unilateral conductive hearing loss, the tuning fork sound will be heard louder in the deaf ear.move to one side, with a relatively small amount of hearing loss (5dB) If the patient is unclear, you may ask if they hear it “everywhere.” Be careful not to ask the question in a leading manner.Then ask the patient: “Do you hear the sound louder in one ear than the other?”.It is important to steady the patient’s head with your other hand so that reasonably firm pressure can be applied.To perform Weber’s test strike the fork against your knee or elbow, then place the base of the fork in the midline, high on the patient’s forehead.Note you should ideally be in a completely silent room for Rinne and Weber tests.Permission (consent and explain examination: “I’m going to examine your hearing using this tuning fork now, is that OK?”).Identity of patient (confirm name and date of birth).Video on Rinne and Weber tests by Oxford Medical Education Other tuning fork tests include the Schwabach and Bing tests, though these are not used in routine practice.The Rinne and Weber tests help distinguish between a conductive hearing loss (CHL) and sensorineural Hearing Loss (SHL).These tests should be carried out with a full examination of the cranial nerves or the ear.Patients with bilateral loss or mixed losses are better assessed with formal pure tone audiometry.They are most useful in patients with unilateral hearing loss which is purely conductive or purely sensorineural.The tuning fork tests provide a reliable clinical method for assessing hearing loss. ![]() How to do Rinne and Weber tuning fork tests for doctors, medical student finals, OSCEs and MRCP PACES In patients with unilateral sensorineural hearing loss, the phase differences and intercochlear intensity lead to vibrations being sensed louder in the contralateral normal ear, causing sound lateralization.Ĭopyright © 2023, StatPearls Publishing LLC.Tuning Fork Tests (Rinne’s and Weber’s tests) Clinical and animal studies have shown that cochlea is stimulated by bone conduction mainly through two routes: The mechanism underlying sound lateralization of the Weber test has been intriguing to health professionals for many decades. In conductive hearing loss, the sound should lateralize to the affected side however, in patients with sensorineural hearing loss, the sound lateralizes to the contralateral side. The Weber test is often combined with the Rinne test to detect the location and nature of the hearing loss. The inner ear mediates sensorineural hearing. The outer and middle ear mediate conductive hearing. The test can detect unilateral conductive and sensorineural hearing loss. The Weber test is a useful, quick, and simple screening test for evaluating hearing loss. ![]() The Weber test has been mainly used to establish a diagnosis in patients with unilateral hearing loss to distinguish between conductive and sensorineural hearing loss. Tuning fork tests have been the mainstay of otologic examination for more than a century. ![]()
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