Use of Rinne's and Weber's Tests to Evaluate a Patient for Deafness

Rinne's and Weber's tests are bedside tests for hearing that can distinguish conductive from perceptive hearing loss.

Terms:

(1) conductive hearing loss = middle ear

(2) perceptive hearing loss = inner ear, sensorineural

Instrumentation: 512 Hz tuning fork

Weber's test:

(1) Place the vibrating fork in the center of the forehead or on a central incisor.

(2) Ask the patient if the vibration is equal in both ears or is more noticeable in the left or right ears.

Rinne's test:

(1) Place the vibrating fork on the mastoid process and record the time it takes to stop (bone conduction).

(2) Then place the vibrating fork 1 inch from the outer ear and record the time it takes to stop (air conduction).

(3) Normally air conduction is >= 2 times bone conduction (positive test).

(4) Abnormal air conduction is when it is < bone conduction (negative test).

(5) An indeterminate test is when air conduction is > 1 time bone conduction but < 2 times.

Hearing Status	Weber's Test	Rinne's Test
normal	equal in both ears	positive (normal) both ears
left conductive loss	lateralizes to left ear	negative (abnormal) left ear
left perceptive loss	lateralizes to right ear	positive (normal) left ear
right conductive loss	lateralizes to right ear	negative (abnormal) right ear
right perceptive loss	lateralizes to left ear	positive (normal) right ear
bilateral conductive loss	equal in both ears	negative (abnormal) in both ears

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