Get to know the Rinne and Weber tests for hearing loss detection

The Rinne tuning fork test and the Weber test are tests for hearing loss, and whether you have conductive or sensorineural hearing loss. This diagnosis is done to get early treatment and determine the right treatment plan. The following is a complete review of the Rinne test and the Weber test.

What are Rinne and Weber tuning fork tests?

A tuning fork test is a hearing check used to help determine the type of hearing loss with the help of a tuning fork. This test is divided into two methods, namely the Rinne and Weber tests.

Rinne test

The Rinne test is a hearing test that is performed to evaluate auditory sounds by comparing the perception of sound delivered by air conduction with bone conduction through the mastoid.

This examination is carried out on one ear. The Rinne test is often recommended for patients with suspected conductive hearing loss.

Weber test

The Weber test is another way to evaluate conductive and sensorineural hearing loss. The Rinne test results should be compared with the Weber test to detect sensorineural hearing loss.

Conductive hearing loss occurs when sound waves are unable to pass through the middle ear to the inner ear. This can be caused by problems in the ear canal, eardrum, or middle ear, such as:

• Ear infection
• Buildup of earwax
• Punctured eardrums
• Fluid in the middle ear
• Damage to the small bones in the middle ear

Sensorineural hearing loss is damage that occurs in any part of the specialized nervous system of the ear. This includes the auditory nerve, hair cells in the inner ear, and other parts of the cochlea. Usually this type of hearing loss occurs due to exposure to noise and increasing age.

What are the benefits of the Rinne test and the Weber test?

The Rinne test and the Weber test are often used because they are easy, including tests that are simple and easy to perform. These two tests are often the first tests used to determine the cause of hearing change or loss in a person.

These tests can help identify conditions that cause hearing loss. Some of the conditions that cause abnormal Rinne or Weber test results include:

• Eardrum perforation
• Earwax
• Ear infection
• Middle ear fluid
• Otosclerosis, is the inability of the small bones in the middle ear (sangurdi bones) to move properly
• Injury to the ear nerves

In addition to those mentioned above, Rinne and Weber's tuning fork tests can be used to confirm the results of the audiometric tests, especially if the results are not symptomatic. In the assessment of a patient with conductive hearing loss, a Weber test is performed to help determine which ear to operate on first.

How is this test procedure done?

The Rinne test and Weber test are performed using a high frequency (512 Hertz) tuning fork to test how you respond to sounds and vibrations near your ears. The following is a procedure description of the Rinne test and the Weber test.

Rinne test

The following procedures are performed in the Rinne test:

1. The doctor places a tuning fork on the mastoid bone (behind one ear).
2. If you can no longer hear sounds, you are asked to give a signal to the doctor.
3. Then, the doctor will move the tuning fork next to your ear.
4. When you can no longer hear the sound, you are asked to give a signal to the doctor.
5. The doctor records how long you hear each sound.

Weber test

The following is the procedure performed in the Weber test:

1. The doctor places a tuning fork in the center of your head
2. You note in which part of the ear the vibration is felt; left ear, right ear, both.

How are the results of this examination?

The following is an interpretation or depiction of the results of Rinne and Weber's tuning fork tests:

Rinne test

Air conduction uses the organs in the ear lobe, eardrum, and ossicles (the three bones of the hearing) to amplify sound and transmit sound to bone conduction. This causes sound to flow directly into the inner ear or through the skull to the other ear.

• Normal hearing, indicating an air conduction time that is twice as long as bone conduction time. In other words, you will hear the sound beside your ear twice as long as you will hear the sound behind your ear.
• Conductive hearing loss, bone conduction sound is heard longer than air conduction.
• Sensorineural hearing loss, air conduction sound is heard longer than bone conduction, but maybe not twice as long.

The Rinne test may show a false negative result. This occurs when a person with severe sensorineural deafness doesn't hear anything from the tuning fork on the mastoid or near the ear canal. The sound travels through the skull to the ear on the other side, so they may not be able to identify in which ear they heard the sound.

Quoted from the National Center for Biotechnology Information, the way to determine the difference between a true and false negative Rinne test is to perform a Weber test.

The Rinne test is only a screening test and cannot replace an audiometric test. In addition, the validity or accuracy of Rinne's test results has also been frequently questioned.

Therefore, if you have any questions about the Rinne test, you will usually be referred for a formal audiometry.

Weber test

• Normal hearing will produce the same vibration in both ears.
• Conductive hearing loss will cause a vibration felt in the ear that is not normal.
• Sensorineural hearing loss will cause vibrations to be felt in the normal ear.

This examination can be complicated if the patient has conductive hearing loss occurring in one ear.