A patient presents to your clinic for evaluation of defective hearing. Rinne's test shows air conduction greater than the bone conduction on both sides with Weber test lateralized to right ear. What is the next logical step?
(A) Normal test (B) Schwabach's test (C) Repeat Rinne's test on right side (D) Wax removal
(B) Ans: B. Schwabach's test(Ref Dhingra 7/e p23, 5/e p25-27)Lateralization of Weber's test to right implies either right-sided conductive deafness or left sided sensorineural deafness.Now in conductive deafness bone conduction is better than air conduction in Rinnie's test, hence the patient probably has sensorineural deafness involving the left ear, as per the findings of Rinnie's and Weber tests.In such a case, Schwabach's test should be performed to see the absolute bone.