If the sound reappears, and AC>BC, this can be thought of as a normal response to the Rinne test (Rinne positive). The Rinne test is used to test for conductive hearing loss and involves placing a high frequency tuning fork (512Hz) against the mastoid bone (BC) and asking the patient to say when he/she stops hearing it-when the patient answers, the tuning fork should be moved quickly to just outside the auditory meatus (AC), and the examiner should ask if the sound reappears. The Rinne test is valuable as a confirmation and also in the special situation of a bilateral CHL with a central Weber test. Experienced clinicians would usually do the Weber test first as it is the quickest way to distinguish between a unilateral CHL and SNHL. If the patient lateralizes the sound to his better hearing ear, it is a SNHL, if he hears it in his worse ear it is a CHL. The Weber test is useful for a conductive as well as a sensorineural hearing loss. It is important that medical students and junior doctors are competent in carrying out these examinations. Two routine tests performed are Rinne and Weber tests.
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