Rinne and Weber hearing tests are two methods for examining hearing loss in an individual. Each test uses a similar tool but different methods to complete the test.
Understanding Hearing Loss
Your ear is made up of many parts, any of which may sustain damage that leads to hearing loss. These parts include:
- Outer ear
- Middle ear
- Inner ear
- Auditory nerve, the pathway that communicates what you hear to your brain
There are many types of hearing loss, and the type depends on the part of the ear that is damaged.
Conductive hearing loss. This happens when something prevents sound from entering through the outer or middle ear.
Sensorineural hearing loss. This type of hearing loss happens when something prevents sound from reaching your inner ear or prevents the hearing nerve from functioning correctly.
Mixed hearing loss. This is a combination of both conductive and sensorineural hearing loss.
Auditory neuropathy spectrum disorder. This happens when damage to your inner ear or auditory nerve scrambles the sounds you hear so that your brain cannot understand.
Hearing loss is also identified by severity:
- Mild hearing loss – You may hear speech, but softer toners are difficult to understand
- Moderate hearing loss – You can hear almost no speech sound when someone speaks in a normal tone and volume
- Severe hearing loss – You can’t understand any speech at a normal tone and volume and only hear some louder sounds
- Profound hearing loss – your hearing loss is severe enough that you cannot understand any speech or sound, no matter the volume
Hearing loss may occur in different stages of life. For example, with prelingual hearing loss, you lose the ability to hear before you’re able to talk. With postlingual hearing loss, you lose the ability to hear after you learn how to talk. It may affect one ear (unilateral) or both ears (bilateral) in varying severity depending on the cause and type of damage that your ear sustained.
Your outer and middle ear help with conductive hearing, while your inner ear helps with sensorineural hearing. The Weber test and Rinne test are often completed back-to-back to determine both the location and type of hearing loss.
Weber Hearing Test
Weber test basics. The doctor places a tool called a struck tuning fork on the bridge of your forehead, your nose, or your teeth. In a normal test, you hear the sound equally through both ears.
How the test works. While more in-depth testing is necessary to determine the degree of hearing loss, the Weber test is a quick way to screen for both conductive and sensorineural hearing loss in one ear or the other.
If the testing sound is stronger in one ear than the other, this is called unilateral conductive loss. This type of test allows the sound to go toward the ear that has better hearing, revealing hearing loss in the other ear.
Air conduction produces a stronger sound than bone conduction for the inner ear. When sound is conducted through your bones, there are more layers of tissue that it has to go through to reach your inner ear and auditory nerve. This may result in a muffled sound. If your ear that has hearing loss is more sensitive to sounds conducted through your bone rather than the air, you may have sensorineural hearing loss.
Rinne Hearing Test
Rinne test basics. The doctor places the base of the struck tuning fork against your mastoid bone behind your ear. They play a sound and ask if you can hear it. Then they move the fork next to your ear and ask again if you can hear the sound. Normally, you can hear with the fork placed beside your ear. If you have conductive hearing loss, you may not hear the sound with the fork at your ear.
How the test works. The Rinne test looks for differences in how your ears hear sound transmitted through the air versus sound transmitted through your bone. While further testing is needed to diagnose the degree of hearing loss, this test is a way to quickly test for conductive hearing loss.
Medical professionals primarily use the Rinne test when they suspect conductive hearing loss. They also use it for patients who have a condition called otosclerosis, to help determine if they are a candidate for surgery.
Similar to the Weber test, hearing is better in the affected ear when the sound conducts through bone. This is because the sound travels more easily to small fibers in your cochlea, the fibers deep in your inner ear that translate sounds. If you have normal hearing, sounds transmitted by bone conduction aren’t as loud because there is no damage to the other functions of your ear.
If you’re concerned about your hearing, talk to your doctor. They may suggest doing these tests. They can work with you to figure out if you have hearing loss and help you decide how to treat it.