Patient with both ear Rinne’s positive and Weber’s test to lateralised to the left. Diagnosis is –
## **Core Concept**
The question assesses understanding of hearing tests, specifically Rinne's test and Weber's test, which are used to differentiate between conductive and sensorineural hearing loss. Rinne's test compares air conduction (AC) and bone conduction (BC), while Weber's test lateralizes sound to assess lateralization in hearing.
## **Why the Correct Answer is Right**
In a patient with Rinne's positive bilaterally, air conduction is better than bone conduction, which is the normal physiological state. When Weber's test lateralizes to the left, it indicates that the left ear is either better at hearing or the right ear has a conductive defect impairing its ability to hear the sound. Given that Rinne's test is positive bilaterally, the lateralization to the left suggests a sensorineural hearing loss in the right ear, as the sound lateralizes to the better ear in cases of unilateral sensorineural hearing loss.
## **Why Each Wrong Option is Incorrect**
- **Option A:** This option is incorrect because if there was a conductive hearing loss in the left ear, Weber's test would lateralize to the left ear, but Rinne's test would be negative in the left ear, which contradicts the given information.
- **Option B:** This option is incorrect because a normal hearing in both ears would not cause Weber's test to lateralize to one side; both tests would be expected to be normal and equal.
- **Option C:** This option is incorrect because if there was a sensorineural hearing loss in the left ear, Weber's test would lateralize to the right ear (the better ear), not the left.
- **Option D:** This option, **Sensorineural hearing loss in right ear**, matches the explanation provided for why the correct answer is right.
## **Clinical Pearl / High-Yield Fact**
A key point to remember is that in sensorineural hearing loss, Rinne's test is positive (AC > BC), and Weber's test lateralizes to the better ear. In conductive hearing loss, Rinne's test is negative (BC > AC), and Weber's test lateralizes to the affected ear.
## **Correct Answer: D. Sensorineural hearing loss in right ear**