A 34-year-old man has left-sided otorrhoea with hearing loss. Tuning fork testing shows the Weber test lateralising to the LEFT ear, and the Rinne test is negative on the left. These findings indicate:

• A Left sensorineural hearing loss
• B Bilateral symmetrical hearing loss
• C Right sensorineural hearing loss
• D Left conductive hearing loss ✓

Explanation

Weber lateralises toward the ear with conductive loss because an occluded or diseased middle ear prevents environmental noise from masking the bone-conducted signal. A negative Rinne on the same side confirms conductive loss greater than about 20 dB. In right sensorineural loss, Weber would lateralise to the LEFT as well, but the Rinne would be positive bilaterally, which kills option C.

Reference: Dhingra's Diseases of Ear, Nose and Throat, 8th ed.

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Written and medically reviewed by the StethoPrep medical team.