A 32-year-old woman presents with gradually progressive unilateral hearing loss. Tuning fork testing shows the fork is heard louder on the affected ear when placed on the vertex (Weber test), and bone conduction exceeds air conduction on the affected side (Rinne test negative). These findings indicate:

• A Sensorineural hearing loss on the affected side
• B Normal hearing with functional overlay
• C Bilateral sensorineural hearing loss
• D Conductive hearing loss on the affected side ✓

Explanation

In conductive loss, ambient noise masks the normal ear during the Weber test, so the fork appears louder in the diseased ear. Bone conduction bypasses the middle ear defect, so it exceeds air conduction (negative Rinne) on that side. In sensorineural loss the pattern reverses: Weber lateralises to the better ear and Rinne is positive bilaterally. This patient's profile, common in early otosclerosis, is therefore classic conductive loss.

Reference: Ganong's Review of Medical Physiology, 26th ed.

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Written and medically reviewed by the StethoPrep medical team.