Which test differentiates conductive vs sensorineural hearing loss?

• A. Visual acuity
• B. Balance disorders
• C. Conductive vs sensorineural hearing loss
• D. Taste disorders

Answer: (C)

Differentiating conductive from sensorineural hearing loss is done with tuning-fork tests that compare how sound is perceived when conduction pathways are challenged differently. The Weber test uses a vibrating tuning fork placed on the midline of the skull. If the sound is heard louder in one ear, that ear’s hearing is functionally different from the other.

In conductive loss, the problem is in the outer or middle ear, so air conduction is reduced on that side. The bone-conducted signal can still stimulate the inner ear, and because the affected ear is less able to compete with the normal ear, the sound is heard louder there. This causes the sound to lateralize to the ear with the conductive problem.

In sensorineural loss, the inner ear or auditory nerve on one side is damaged, so that ear perceives less sound overall. The intact ear tends to hear the tones louder, so the Weber tune lateralizes to the normal (unaffected) ear.

Because this pattern helps distinguish whether the issue lies in conduction versus neural pathways, the Weber test is especially helpful for differentiating conductive from sensorineural hearing loss. A complementary test, like the Rinne test, can provide additional detail by comparing air conduction to bone conduction in each ear, but the Weber test is the primary tool for this specific differentiation.