A patient has Rinne test +ve for left ear and weber test is lateralized to right ear, what type of deafness may be seen in this case?
**Core Concept**
The Rinne test assesses the air-bone gap by comparing the patient's ability to hear air conduction (AC) to bone conduction (BC). A positive Rinne test indicates that AC is better than BC. The Weber test lateralizes sound to one ear, suggesting a difference in hearing sensitivity between the two ears. In this case, the patient's left ear is better at air conduction (Rinne test +ve), while sound is lateralized to the right ear (Weber test).
**Why the Correct Answer is Right**
A positive Rinne test in the left ear indicates that the left ear's air conduction is better than its bone conduction. This suggests that the left ear is not impaired in its ability to conduct sound through the air. However, the Weber test lateralizes sound to the right ear, which implies that the left ear is actually worse at detecting sound through bone conduction. This is a hallmark of sensorineural hearing loss (SNHL), as it affects the inner ear or the auditory nerve. In contrast, conductive hearing loss (CHL) would result in a negative Rinne test due to poor air conduction.
**Why Each Wrong Option is Incorrect**
**Option A:** A left conductive hearing loss (CHL) would result in a negative Rinne test, not a positive one.
**Option B:** A right conductive hearing loss (CHL) would not explain the lateralization of sound to the right ear on the Weber test.
**Option D:** A right sensorineural hearing loss (SNHL) would not explain the positive Rinne test in the left ear.
**Clinical Pearl / High-Yield Fact**
In cases where the Rinne test is positive in one ear and the Weber test lateralizes sound to the other ear, it is essential to investigate for sensorineural hearing loss, particularly in the ear with the lateralized sound on the Weber test.
✓ Correct Answer: C. Left sensorineural HL