Weber Test
Purpose
The Weber test was invented to make a diagnoses in patients with unilateral hearing loss to established if it is either conductive or sensorineural hearing loss. [1]
Technique
Equipment
- 512 Hz Tuning fork- This tuning forks works best, because it supplies the best balance of time, tone decay and tactile vibration.[2]
- 256 Hz Tuning fork- The 256 Hz and the 128 Hz tuning forks respectively are normal used in a neurological examination due to their characteristics of greater tactile vibrations.[3] Evidence however suggest that the 512 Hz provides better reliability compared to the 256 Hz. [4]
Operate the tuning fork:
- Hold the the tuning fork between your first finger and thumb by the stem.
- Strike the prong ( one third of the way) onto a elastic but firm object for example the clinicians elbow or knee. A relatively pure tone will be produced by doing this. Do not strike the tines onto a hard surface, this can damage the tuning fork and can produce multiple overtones.
Preparations
- Ideally the test should be performed in a quiet room.
- Instructions should be clear so that there is no misunderstandings and the test can be interpreted correctly.
Administer
- Place the tuning fork on the crown of the head. The other common places that you can use are the middle of the forehead, the chin or the bridge of the nose halfway from both ears. The vibrations will be transmitted through the skull and reach the cochlea.
- The patient is then asked whether they can hear the sound the loudest in either side of the head or just in the midline.
The above video shows how the Weber test is performed. Showing that the tuning fork is placed on the patients center of her head and the clinician asks her to indicate whether the sound is the same or different in her ears.
Interpretation
Normal: In a patient who does not have hearing loss the sound will be heard in the middle and the same on both sides.
Unilateral Sensorineural hearing loss: The sound is heard louder in the unaffected hear. Something to note, if there is a abnormal or absent response in the affected ear it indicate a severe sensorineural hearing loss. This would be considered a false negative result.[1]
Unilateral Conductive hearing loss: The sound is heard louder in the affected ear.[1]
Symmetrical Conductive hearing loss: The sound is heard equally in both ears.
Evidence
One study reviewed sixty patients from the emergency department with unilateral hearing loss. The Weber Test showed a sensitivity of 84.6% and a specificity of 94.1%[6]
References
- ↑ 1.0 1.1 1.2 Bassiouni M, Häußler SM, Gräbel S, Szczepek AJ, Olze H. Lateralization Pattern of the Weber Tuning Fork Test in Longstanding Unilateral Profound Hearing Loss: Implications for Cochlear Implantation. Audiology Research. 2022 Jun 21;12(4):347–56.
- ↑ Wahid NWB, Attia M. Weber Test [Internet]. Nih.gov. StatPearls Publishing; 2019.
- ↑ Bayoumy AB, Ru JA de. Sudden deafness and tuning fork tests: towards optimal utilisation. Practical Neurology [Internet]. 2020 Feb 1 [cited 2021 Jan 20];20(1):66–8.
- ↑ Ungar OJ, Handzel O, Oron Y, Warshavsky A, Horowitz G, Yafit D, et al. Weber test accuracy in sudden sensorineural hearing loss: which frequency is best? Acta Oto-Laryngologica. 2021 Feb 13;141(5):502–5.
- ↑ Weber test by Cardio Ped available from:https://www.youtube.com/watch?v=nY55PlUki1A
- ↑ Ungar Omer J, Handzel O, Cavel O, Oron Y. A Smartphone-Based Weber Test May Discriminate between a Conductive and a Sensorineural Hearing Loss. Audiology and Neurotology. 2019;24(4):191–6.