Tuning Fork Test

Aka: Tuning Fork Test, Weber Test, Weber's Test, Rinne Test, Rinne's Test

1. Indication: Differentiate Hearing Loss cause
   1. Sensorineural Hearing Loss
   2. Conductive Hearing Loss
2. Preparation
   1. Tuning fork should be 512 Hz (preferred) to 1024 Hz
3. Test: Weber
   1. Technique: Tuning Fork placed at midline forehead
   2. Normal: Sound radiates to both ears equally
   3. Abnormal: Sound lateralizes to one ear
      1. Ipsilateral Conductive Hearing Loss (louder in the defective ear) OR
      2. Contralateral Sensorineural Hearing Loss (louder in the unaffected ear)
4. Test: Rinne
   1. Technique
      1. First: Bone Conduction
         1. Vibrating Tuning Fork held on Mastoid
         2. Patient covers opposite ear with hand
         3. Patient signals when sound ceases
         4. Move the vibrating tuning fork over the ear canal
            1. Near, but not touching the ear
      2. Next: Air Conduction
         1. Patient indicates when the sound ceases
   2. Normal: Air Conduction is better than Bone Conduction
      1. Air conduction usually persists twice as long as bone
      2. Referred to as "positive test"
   3. Abnormal: Bone conduction better than air conduction
      1. Suggests Conductive Hearing Loss
      2. Referred to as "negative test"