In a patient, Weber test lateralizes to the right ear and Rinne test is negative in the right ear. What type of hearing loss is present?

Appeared in: NORCET 10 Mains

Explanation

In conductive hearing loss, the Weber test lateralizes to the affected ear because the bone-conducted sound bypasses the obstruction and is perceived louder due to the masking of ambient noise.
A negative Rinne test (Bone Conduction > Air Conduction) in the right ear specifically indicates a problem with sound transmission through the outer or middle ear on that side.
The combination of Weber lateralizing to the right and a negative Rinne in the right ear is the classic presentation of conductive hearing loss in the right ear.

Option B: With sensorineural hearing loss in the right ear, the inner ear or nerve is damaged. Therefore, sound would be perceived better in the healthy, unaffected left ear.
Option C: The findings are specific to the right ear. If there were conductive hearing loss in the left ear, the Weber test would lateralize to the left.
Option D: The patient has abnormal test results. In normal hearing, the Weber test does not lateralize, and the Rinne test is positive (Air Conduction > Bone Conduction).

Clinical Relevance

Nursing practice connection: Use the key finding related to Interpretation of Weber and Rinne tests for hearing loss to guide bedside assessment, documentation, and the next nursing action.
Nurses frequently perform or assist with basic hearing screenings in various settings, including clinics, schools, and hospitals. Correctly interpreting these initial tests is vital for timely patient referral to an audiologist or ENT specialist.
Understanding the difference between conductive and sensorineural loss helps the nurse anticipate patient needs. Conductive loss may be due to treatable causes like earwax impaction or infection, while sensorineural loss is often permanent.
What if? If the Weber test lateralized to the right ear, but the Rinne test was positive in both ears, the diagnosis would change. This pattern suggests sensorineural hearing loss in the left ear, as the sound lateralizes to the better-hearing (right) ear.

How to Approach the Question

First, analyze the Weber test result. Lateralization to the right ear narrows the possibilities to either conductive loss in the right ear or sensorineural loss in the left ear.
Next, analyze the Rinne test result for the right ear. A 'negative' result means Bone Conduction (BC) is greater than Air Conduction (AC).
Recall that BC > AC is the defining characteristic of a conductive hearing loss.
Combine the two findings: The Weber test points towards the right ear, and the Rinne test confirms the problem is conductive in nature.
Therefore, the diagnosis is conductive hearing loss in the right ear. Evaluate the other options to confirm they are inconsistent with this conclusion.

Concept Tested & Keywords

Concept Tested: Interpretation of Weber and Rinne tests for hearing loss.
Stem keywords: Weber test, Rinne test, lateralizes to the right ear, negative in the right ear
Lead-in keywords: What type

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