Unilateral conductive hearing loss may indicate external or middle ear disease.PEARLS (Kong & Fowler, 2022 Wahid, Hogan & Attia, 2022 Weber, 2022) The patient should then be referred for audiogram testing. A normal Rinne test in the contralateral ear may indicate sensorineural hearing loss. If the Weber test lateralizes to an ear in which the Rinne test is normal, perform the Rinne test in the opposite ear.An abnormal Rinne test (bone is better than air conduction) may indicate conductive loss if the Weber test also lateralizes to that side.Together, the Weber and Rinne tests can help determine if the patient’s hearing loss is conductive or sensorineural in nature. Abnormal result is observed when sound is at least equally loud or louder when the fork is placed on the bone compared to when it is held next to the ear (i.e., bone is better than air conduction).Īnalyzing Results of the Weber and Rinne Tests Together (Weber, 2022).Normal result is observed when the vibrating fork positioned near the ear is louder and lasts twice as long than when placed on the mastoid bone (i.e., air conduction is better than bone conduction).When the patient can no longer hear the vibration on the mastoid process, move the vibrating tuning fork near the external auditory canal and ask the patient to tell you when the sound can no longer be heard.Ask the patient to cover the other ear with their hand and to report when the sound can no longer be heard.Using a 512-Hz tuning fork, strike the tines on your forearm just in front of your elbow and place the stem of the fork on the mastoid bone behind the ear.This comparison also helps to assess unilateral hearing loss. The Rinne test helps to discerns sound transmitted through air versus sound transmitted through bone. Rinne Test (Kong & Fowler, 2022 Weber, 2022) Symmetrical conductive hearing loss is observed if the patient does not exhibit lateralization.Unilateral conductive hearing loss is observed if the patient hears the sound louder (lateralizes) in the affected or “bad” ear.Unilateral sensorineural hearing loss is observed if the patient hears the sound louder (lateralizes) in the unaffected or “good” ear.Normal hearing is confirmed when the sound is heard midline and equally on both sides.Ask the patient “Is the sound louder in your right ear, left ear, or the same on both sides?”.The vibrations travel through the skull to the cochlea. Other sites such as the chin or bridge of nose, are sometimes used. Using a 512-Hz tuning fork, strike the tines on your forearm just in front of your elbow and place the stem of the fork on the top of the head or midline of the forehead.The Weber test is primarily used to assess patients with unilateral hearing loss and to characterize conductive versus sensorineural loss. Weber Test (Wahid, Hogan & Attia, 2022 Weber, 2022) Two quick and easy tests, used in conjunction, that can further distinguish between the different types of hearing loss are the Weber and Rinne tests. Hearing loss is initially evaluated on routine physical examination using simple tools such as the whispered voice test, otoscopes, and tuning forks. Mixed loss: is a combination of both conductive and sensorineural hearing loss.Conductive: caused by factors that limit the amount of sound that enters the inner ear such as ear wax buildup or middle ear fluid.Sensorineural: the sound-transducing system that involves the inner ear, cochlea, and auditory nerve.In general, hearing loss can be classified into three types (Weber, 2022 Wahid, Hogan & Attia, 2022): For example, short term hearing loss can be caused by a common ear infection, which often resolves with treatment and time, while permanent hearing loss will afflict many of us as we grow older. Hearing loss can occur at any stage of life for a variety of reasons. Facing Ethical Challenges with Strength and Compassion.Establishing Yourself as a Professional and Developing Leadership Skills.Ensuring Patient & Family Centered Care.Developing Critical Thinking Skills and Fostering Clinical Judgement.Alteplase Injection for Acute Ischemic Events.Affirming Care for Patients who are LGBTQ+.Lippincott Clinical Conferences On Demand. Continuing Education Bundle for Nurse Educators.Lippincott NursingCenter’s Critical Care Insider.Lippincott NursingCenter’s Career Advisor.Academic/Practice Innovation: An Interview with Dr.Becoming Great in Healthcare: Webinar Highlights.People Connections and Building Relationships: An Interview with Cathleen Wheatley.Teamwork is the Bedrock of a High Trust Culture.
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