Hearing test should be done using voice discrimination or sound discrimination (ticking of a watch).

Rinne, Weber and Schwabach Hearing Tests differentiate neural from conductive problems.

Hearing Tests

Rinne Test	Compares air conduction (AC) and bone conduction (BC). Tunning fork (512MHz) on the mastoid bone (BC), when the sound is no longer perceived, place the fork next to the ear -one inch- to test AC. Normal = AC > BC
Weber Test	Lateralization test (BC). Place the handle of the tunning fork on the vertex. Ask whether the sound is equally loud in both ears or louder in one side.
Schwabach Test	Compares BC with normal observer.

Hearing	Rinne's	Weber's

Normal	AC > BC bilaterally	midline
Conductive loss	BC > AC affected ear AC > BC normal ear	lateralizes to affected ear
Sensorineural loss	AC > BC both ears	lateralizes to normal ear
KEY: AC= air conduction. BC= bone conduction.