Clinical Assessment: Weber Test
Use a 512 Hz tuning fork placed on the midline of the skull or forehead. Ask the patient whether the sound is equal bilaterally or louder in one ear. Perform alongside the Rinne test.
Weber Test
A clinical tuning-fork test that detects unilateral hearing loss and helps differentiate conductive from sensorineural causes by testing lateralisation of bone-conducted sound. Named after Friedrich Eugen Weber (1834).
Administration protocol:
- Strike a 512 Hz tuning fork and place the base firmly on the midline of the patient's forehead, top of the skull, or teeth.
- Ask: "Do you hear this sound in the middle of your head, or is it louder in one ear?"
- Record whether the sound lateralises and to which side.
Interpretation reference
Weber Lateralises to the Affected (Worse) Ear
Patient reports hearing the vibration louder in the symptomatic or worse-hearing ear.
Suggests conductive hearing loss in the affected ear. Bone conduction is enhanced on the side of conductive loss because masking noise from the environment does not reach that cochlea.
Correlate with Rinne test. Otoscopy and referral to audiology/otolaryngology for evaluation of conductive pathology (cerumen, effusion, ossicular chain problem).
Weber Lateralises to the Unaffected (Better) Ear
Patient reports hearing the vibration louder in the better-hearing ear or the side without symptoms.
Suggests sensorineural hearing loss in the opposite (affected) ear. The cochlea with intact function receives the signal preferentially.
Correlate with Rinne test findings. Referral for audiogram and further assessment for sensorineural causes.
Weber Does Not Lateralise (Midline)
Patient hears sound equally in both ears or centrally.
Normal finding, or symmetric hearing loss bilaterally.
Document as non-lateralising. Correlate with Rinne test and auditory history.