A 70-year-old patient with bilateral symmetric high-frequency sensorineural hearing loss (presbycusis) undergoes Weber's test with a 512 Hz tuning fork placed on the forehead midline. The patient reports hearing the sound equally in both ears. What is the correct interpretation?

• A Conductive hearing loss in the right ear
• B No lateralization; consistent with symmetric bilateral hearing loss ✓
• C Sensorineural hearing loss in the left ear
• D Bilateral conductive hearing loss

Explanation

Weber test lateralizes to the better hearing (or more conductive-loss-affected) ear when asymmetric. In symmetric bilateral hearing loss (whether sensorineural or conductive), there is no lateralization, and the sound is heard equally or in the midline. Weber alone cannot distinguish between symmetric sensorineural and conductive loss; it must be combined with Rinne test.

Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.