Weber and Rinne Test - Clinical Examination

The clinical examination of hearing loss should include differentiating between conductive and sensorineural hearing loss. There are different causes of sensorineural hearing loss, such as inner ear disease or damage to the cochlear nerve. In all cases, the perception of sound waves via both air and bone conduction is impaired. Sounds reaching the affected ear will therefore be perceived to be quieter than on the unaffected side.

Conductive hearing loss on the other hand is caused by diseases of the middle ear, such as otosclerosis or otitis media. Obstruction of the outer auditory canal, as seen in cerumen impaction, for example, can also lead to conductive hearing loss. In this case, air conduction of sound waves from middle to inner ear is impaired. Bone conduction, however, is unaffected and causes sounds on the affected side to appear louder.

There are two hypotheses that attempt to explain this phenomenon. First, it is assumed that impaired sound conduction causes upregulation of the inner ear, which makes it more sensitive towards stimuli received via bone conduction. It also causes these sounds to be perceived as louder. Second, if sound waves cannot easily reach the inner ear, they probably cannot exit it easily either. These trapped sound waves could therefore make patients perceive sounds as louder.

The Rinne and Weber tests are easy and quick methods for differentiating simple forms of conductive and sensorineural hearing loss. More complex illnesses, such as combined conductive and sensorineural hearing loss, often result in test results that are difficult to interpret.

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[Mike-gogb]

To clear up a point of possible confusion it's Important to note that a normal result for Rinne's test is paradoxically called a positive Rinne test.

[wolfymilk]

I've been struggling to understand how to interpret these tests for the last 4 years of med school. FINALLY I understand. Thank you so much for this video. You're a godsend!

[michaelaarons]

My textbook has the COMPLETE opposite written for the results of the Weber test and has been confusing me for hours. Thank you for clearing this up

[bimihadz]

I find really this demonstration the most comprehensive and instructive on these tests

[eloisety]

The best discussion about weber and rinne..even better than my professors😂
Especially when they gave examples..it made it even more clear.thank you so so much!

[asharedo]

Very good explanation - one of the better youtube videos I've seen describing examinations like this.

[christerfaakuse]

Keep coming back to this!
Excellent video!

[lee-annechazanga]

I've spent so much time browsing through videos and failing to understand until this particular thank you much this makes me feel better since i had missed the prac class initially.

[doctorshocker]

cant explain how easily that was illustrated, loved it

[walemuse]

Excellent illustration. 
I love the tests at the end of the explanations, I had to pause the video and I got the answers correctly following the brief explanation. I'll recommend this all day long

[NelsonKlahr]

We used your vides today in Neurophysiology Lab at NUHS Pinellas Park, FL. THANK YOU!

[nahommulatu]

thanks so so much.. this is the best video on this subject

[drinaciofernandes]

this is by far the best video ive seen on these tests.


the key statement was this



" physiologically Air conduction is better than Bone conduction "


a misconception that i had was that when it was said conduction, i always used to think in terms of BONE only.

[jesseschulz]

Great description and I really liked the example cases at the end! Thank you for posting, this was done in a very easy to digest way

[emekaemmanuel]

Lets just acknowledge that Amboss is the best thing that has ever happened to clinical medical education.

[snehasnow]

After watching this video 4times... I finally understood the concept well.. Thanks for uploading

[lotusman]

Only time this has ever begun to make sense for me thank you

[staneciawynter]

Good stuff, I've spent the first 3 years of med skl not understanding this concept at all!!! I think I finally get it.

[alimiri]

Best video ever seen about the subjects. The idea of analyzing some questions about the tests was also great. Thanks a lot.

In 1st year of PT school, one of our lab practicals was to demonstrate and explain both of these tests in 1 minute.