A 32-year-old man with progressive bilateral hearing loss has Rinne negative in both ears and Weber central. When the external auditory canal is occluded with a finger during bone-conduction testing with a 512 Hz fork, he reports NO change in loudness (negative Bing test). This finding supports:

• A Normal hearing
• B Sensorineural hearing loss
• C Otitis media with effusion
• D Fixation of the stapes footplate ✓

Explanation

The Bing test relies on the occlusion effect: closing a normal mobile ear canal traps bone-conducted sound and makes it louder (positive Bing) in normal hearing and sensorineural loss. When the stapes footplate is fixed, as in otosclerosis, the occlusion effect is abolished and the test is negative. Combined with a negative Rinne and central Weber, the negative Bing confirms bilateral conductive loss from stapes fixation rather than effusion, which usually gives variable results.

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

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Written and medically reviewed by the StethoPrep medical team.