Which assessment test differentiates conduction from sensorineural hearing loss?

• A. Rinne test
• B. Weber test
• C. Romberg test
• D. Snellen chart

Answer: (B)

The main idea here is how sound is heard when a tuning fork is placed on the midline of the skull. The Weber test uses bone-conduction sound to compare both ears at once. If the sound seems louder in the ear with a problem, that points to a conductive issue on that side, because the outer or middle ear can’t conduct sound well, so the brain ends up relying more on the bone-conducted signal in that ear. If instead the sound is louder in the normal, unaffected ear, that suggests a sensorineural problem in the opposite ear—the inner ear or cochlear nerve isn’t picking up sound as well there, so the normal ear dominates.

So this test helps tell apart conductive versus sensorineural loss on one side by see-sawing where the sound is heard louder. If the sound is heard equally in both ears, the hearing is likely normal or there is symmetric loss. The other tests mentioned assess different functions: the Rinne test compares air versus bone conduction to identify conductive loss but isn’t as direct for lateralizing between types; the Romberg test checks balance, and the Snellen chart measures vision.