Rinne & Weber test – Physical Exam

RINNE & WEBER TESTS:

Rinne & Weber tests are exams that test for hearing loss. They determine whether a patient has conductive or sensorineural hearing loss. This determination allows a doctor to come up with a treatment option. Both tests are used to evaluate a patient’s hearing. Early identification allows patients to get treatment before problems progress to total hearing loss.

Rinne test compares air- and bone-conduction hearing. Air-conduction hearing occurs through air near the ear, and bone-conduction hearing occurs through vibrations.

Weber test determines whether an issue is conductive or sensorineural hearing loss. Conductive hearing loss occurs when sound waves are not able to pass through the inner ear. This can be caused by an infection, a buildup of earwax, a punctured eardrum, and fluid in the middle ear. Sensorineural hearing loss occurs when auditory nerves or hair cells are damaged in the inner ear. This is also known as “nerve deafness,” and it is caused mostly by aging.

 

How to perform Rinne & Weber tests:

Rinne Test:

1) The doctor strikes a tuning fork and places it near the base of your mastoid bone.
2) The doctor asks you to say when you no longer hear the sound.
3) The doctor notes the time and moves the tuning fork near the ear canal.
4) The doctor asks you to say when you no longer hear the sound.
5) The doctor compares the time intervals for the two steps.

Weber Test:

1) The doctor strikes a tuning fork and places it on the middle of your head.
2) The doctor asks you where the sound is coming from: the left ear, the right ear, or both.

 

What are the results of Rinne & Weber tests:

Rinne Test Results:

– Normal hearing will show an air-conduction time that is twice as long as the bone conduction. In reference to the administration steps described earlier, the second time would be twice as long as the first.
– If a patient has conductive hearing loss, the bone conduction sound is longer than or equal to the air conduction sound.
– If a patient has sensorineural hearing loss, air conduction is heard longer than bone conduction, but it is not heard to be twice as long.

Weber Test Results:

– Normal hearing will indicate sound in both ears.
– Conductive loss will indicate the sound travels towards the poor ear.
– Sensorineural loss will indicate the sound travels towards the good ear.

DIFFERENTIAL DIAGNOSIS for Hearing loss

  • Presbycusis
  • Cochlear N. damage due to loud noise
  • Otosclerosis
  • Ménière disease
  • Neurofibromatosis
  • Ototoxicity (loop diuretics, antibiotics like tetracyclines & aspirin in the History)

 


A demonstration of how to perform a crude hearing test as well as Rinnes and Webers hearing tests using a tuning fork. These tests can help detect conductive or sensorineural deafness.

Correction to original video: In Webers test if the sound is heard louder in the good ear it would indicate sensorineural hearing loss.

 

 

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