Weber test can detect unilateral (one-sided). However, evidence suggests that the 256-Hz provides better reliability when compared to the 512-Hz. The Weber test is a test of lateralization and is of most value useful in those with an asymmetrical hearing loss. His grand achievement, however, passed unnoticed at his time. The 256-Hz tuning fork and the 128-Hz tuning fork are commonly used as part of neurological examination due to their greater tactile vibration characteristic. Schmalz, an otologist in Dresden, Germany, in 1845 introduced the tuning fork and the test later named after Weber into otology and explained in great detail all possibilities of a diagnostic evaluation of the test. Higher-frequency tuning forks, for example, the 1024-Hz tuning fork, have a shorter tone decay time. In other words, they are better felt than heard. Lower-frequency tuning forks like the 256-Hz tuning fork provide greater tactile vibration. At this frequency, it provides the best balance of time of tone decay and tactile vibration. In clinical practice, the 512-Hz tuning fork has traditionally been preferred. Occasionally, one can get a mixed hearing loss, which is a combination of the two types of hearing loss.Īn ideal tuning fork of choice for the Weber test would be one that has a long period of tone decay in other words, the tone maintains/lasts long after the tuning fork has been struck and cannot be detected by the sense of bone vibration, therefore preventing misinterpretation of the vibration as sound. Conductive hearing loss is due to problems with the sound-conducting system, while sensorineural hearing loss is due to problems with the sound-transducing system, the auditory nerve, or its central pathways. The Weber test, along with its paired Rinne test, is commonly used to distinguish the site and likely cause of hearing loss. Hearing loss may occur due to interruption at any point along these pathways. However, sound can also be transmitted via bone conduction, where vibrations are transmitted via the skull and delivered directly to the cochlea, buried within the temporal bone. The cochlea plays an important role in transducing these vibrations into nerve impulses via the auditory nerve (vestibulocochlear nerve), which is then delivered along the central pathways to the auditory cortex, where it is processed and perceived as sound. The sound vibrations are then transmitted through the middle ear via the ossicular chain before reaching the cochlea. I hope to make this subject as easy to understand as possible for the busy. The purpose of the outer ear is to direct sounds onto the tympanic membrane. Due to Popular demand - i have written this short guide purely on tuning fork tests. The inner ear: Cochlea (organ of hearing), vestibular labyrinth (organ of balance)