What is the clinical significance of unilateral hearing loss with right-sided lateralization on Weber’s test and a positive left-sided Rinne’s test?

Unilateral hearing loss with right-sided lateralization on Weber’s test and a positive left-sided Rinne’s test is indicative of left-sided sensioneural hearing loss.

Weber’s test detects where sound is localized; in conductive hearing loss, the sound will be localized (louder) in the affected ear, while in sensioneural hearing loss, the sound will be localized to the unaffected ear. Thus, from the question, right-sided lateralization on Weber’s test indicates either right-sided conductive hearing loss or left-sided sensioneural hearing loss. Rinne’s test is used to differentiate between the two.

Rinne’s test detects differences in bone and air conduction; in conductive hearing loss, air conduction will be less than bone conduction (AC < BC), which is considered a negative Rinne’s test. In sensioneural hearing loss, air conduction will be longer than bone conduction (AC > BC), which is considered a positive Rinne’s test.

Remember, in cases of conductive hearing loss, it is important to rule out cholesteatoma, which can lead to temporal bone infection and meningitis, while in sensioneural hearing loss, acoustic neuroma and Meniere’s disease should be ruled out.

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This post was written by Omar Rifai