ENT Dr. ASM

1

Rinne and Weber tests

Rinne’s test indicates the person’s ability to discriminate between air and bone conduction of sound

To test bone conduction the base of a tuning fork is held on the mastoid process, with air conduction it is held

about 1 inch in front of the ear

The patient is then asked to compare the loudness of the two sounds

A positive Rinne’s test is when air conduction is heard better than bone, negative is when converse is found

In the Weber’s test the tuning fork is held of the vertex of the head and the patient indicates where it lateralizes

(if it does). The test result here is intended to indicate a bilateral sensorineural hearing loss but this could be a

normal test

If the Rinne’s test is positive on the right, negative on the left and the Weber’s is to the right → left profound

sensorineural hearing loss

If the Rinne’s test is positive on the right, negative on the left and the Weber’s is to the left → left conductive

hearing loss

If the Rinne’s is negative bilateral and the Weber’s test is central → bilateral mixed or conductive hearing loss

Simple interpretation of the Rinne and weber tests

Firstly see the Rinne test → it is negative in the diseased ear (either CHL or SNHL)

If the Rinne’s test is positive on the right and negative on the left → the left ear is diseased

If the Rinne’s test is negative on the right and positive on the left → the right ear is diseased

Now, look to the weber test

If the weber test is toward the diseased ear (heard by the diseased ear) → the inner ear is intact → CHL

If the weber test is toward the normal ear (away from the diseased ear) → SNHL

Examples

Weber’s test – localising to right ear. Rinne’s test – left ear positive, right ear negative → right CHL

Weber’s test – localising to right ear. Rinne’s test – right ear positive, left ear negative → left SNHL

Weber’s test – equal. Rinne’s test positive in both ears → normal

Weber’s test – localising to left ear. Rinne’s test – right ear positive, left ear negative → left CHL

Weber’s test – localising to left ear. Rinne’s test – right ear negative, left ear positive → right SNHL

Weber’s test – equal. Rinne’s test – negative in both ears → bilateral mixed or CHL