Patient will present as → a 25-year-old patient presents with unilateral hearing loss. Weber reveals lateralization to the right ear. Rinne test reveals the following: RIGHT: bone conduction = 10 seconds, air conduction = 5 seconds; LEFT: bone conduction = 5 seconds, air conduction = 10 seconds.
Cerumen impaction—buildup obstructs the auditory canal and is the most common cause of conductive hearing loss
Rinne and Weber Tests
Conductive loss
- Abnormal Rinne test—bone conduction is better than air conduction
- Weber—sound lateralizes to the affected side (tuning fork is perceived more loudly in the ear with a conductive hearing loss)
Sensorineural loss
- Normal Rinne test—air conduction is better than bone conduction
- Weber—sound lateralizes to the unaffected side
Cerumen impaction is best treated by irrigation after several days of softening with carbamide peroxide (Debrox) or triethanolamine (Cerumenex)
Question 1 |
cerumen impaction in the right ear | |
effusion in the left ear Hint: An effusion or otitis media could potentially cause a conductive hearing loss in the affected ear. The Weber test will lateralize to the left ear and bone conduction will be longer than air conduction in the left ear. | |
otitis media in the left ear Hint: See B. | |
pain on palpation of tragus or mastoid area Hint: Otitis externa and mastoiditis are not associated with hearing loss. |