In the case where the patient is unaware or has acclimated to their hearing loss, the clinician has to use the Rinne test in conjunction with the Weber to characterize and localize any deficits. by the patient telling the clinician that they cannot hear as well in one ear as in the other), with the testing is being done to characterize the type, conductive or sensorineural, of hearing loss that is occurring. However, this assumes that it is known which ear is defective and which is normal (e.g. Also in the affected patient, if the normal ear hears the tuning fork sound better, there is sensorineural hearing loss on the other (defective) ear. In an affected patient, if the defective ear hears the Weber tuning fork louder, the finding indicates a conductive hearing loss in the defective ear. A normal Weber test has a patient reporting the sound heard equally in both sides. The patient is asked to report in which ear the sound is heard louder. In the Weber test a vibrating tuning fork (Typically 256 Hz or 512 Hz used for Weber vibration test 512 Hz used for Rinne hearing test) is placed in the middle of the forehead, above the upper lip under the nose over the teeth, or on top of the head equidistant from the patient's ears on top of thin skin in contact with the bone. The Weber and the Rinne test ( / ˈ r ɪ n ə/ RIN-ə) are typically performed together with the results of each combined to determine the location and nature of any hearing losses detected. The Weber test has had its value as a screening test questioned in the literature. The outer ear consisting of the pinna, ear canal, and ear drum or tympanic membrane transmits sounds to the middle ear but does not contribute to the conduction or sensorineural hearing ability save for hearing transmissions limited by cerumen impaction (wax collection in the ear canal). Sensorineural hearing ability is mediated by the inner ear composed of the cochlea with its internal basilar membrane and attached cochlear nerve (cranial nerve VIII). Conductive hearing ability is mediated by the middle ear composed of the ossicles: the malleus, the incus, and the stapes. The test is named after Ernst Heinrich Weber (1795–1878). It can detect unilateral (one-sided) conductive hearing loss (middle ear hearing loss) and unilateral sensorineural hearing loss (inner ear hearing loss). The Weber test is a screening test for hearing performed with a tuning fork. The findings may suggest a role for the Weber test as a simple, quick, and economical tool for screening poor cochlear implant candidates, thus potentially supporting the decision-making and counseling of patients with longstanding single-sided deafness.Īudiometry hearing loss single-sided deafness tinnitus tuning fork.The Weber test is administered by holding a vibrating tuning fork on top of the patient's head. This notion may partially explain the poor outcome of adult cochlear implantation in longstanding single-sided deafness. The findings may imply a central adaptation process due to chronic unilateral auditory deprivation starting before the critical period of auditory maturation. In this patient cohort, childhood-onset unilateral profound hearing loss was significantly associated with the lack of lateralization of the Weber tuning fork test (Fisher’s exact test, p < 0.05) and the absence of tinnitus in the affected ear (Fisher’s exact test, p < 0.001). In the present study, we conducted a retrospective analysis of the medical records of patients with unilateral profound hearing loss (single-sided deafness or asymmetric hearing loss) for at least ten years. The observation that the Weber test does not lateralize in some patients with longstanding unilateral deafness has been previously described but remains poorly understood. Sound should typically lateralize to the contralateral side in unilateral sensorineural hearing loss. The Weber tuning fork test is a standard otologic examination tool in patients with unilateral hearing loss.
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