Family Nurse Practitioner Exam

Which of the following conditions is more likely to present with a lateralization in the Weber test?

1. Earwax blockage

2. Normal hearing

3. Age-related hearing loss

4. None of the above

The correct answer is: Earwax blockage

The Weber test is a simple clinical test used to assess hearing. In this test, a tuning fork is placed on the center of the forehead, and the patient is asked to indicate where they hear the sound. In cases of conductive hearing loss, the sound will lateralize to the affected ear, while in sensorineural hearing loss, the sound will lateralize to the unaffected ear. When considering earwax blockage (cerumen impaction), it creates a conductive hearing loss because the blockage prevents sound from effectively reaching the inner ear. Therefore, during the Weber test, the sound is perceived more strongly in the ear with the blockage, resulting in lateralization towards that affected side. In contrast, other options such as normal hearing or age-related hearing loss (presbycusis) do not typically cause significant lateralization in the Weber test. Normal hearing should result in a perception of sound in the midline, while age-related hearing loss often involves bilaterally symmetrical sensorineural loss, which would lead to lateralization towards the better-hearing ear but not typically to a significant extent. Understanding these mechanisms clarifies why earwax blockage is the condition that will show lateralization during the Weber test, as it directly affects sound conduction in the ear where the