How do the Rinne test and Weber test help distinguish types of hearing loss?

Tuning-fork tests are qualitative tools used to differentiate between conductive hearing loss and sensorineural impairment by comparing how sound is perceived through the air versus the bones of the skull.1

The Rinne Test

The Rinne test compares air conduction to bone conduction.1
* Positive Result: The sound is heard longer through the air than through bone. This is normal or indicates incomplete sensorineural impairment.1
* Negative Result: The sound is heard longer through bone than through air, which indicates conductive deafness.1

The Weber Test

The Weber test involves placing a vibrating fork on the forehead to determine where the sound is localized.1
* Sensorineural Lesion: The sound is localized to the "better" (unaffected) ear.1
* Conductive Defect: The sound is localized to the "worse" ear, as that ear is shielded from ambient noise, making bone-conducted sound more apparent.1

These tests are essential for clinical diagnosis, such as identifying otosclerosis.1