In a Weber test, what does it signify if the tone is louder in the affected ear?

In a Weber test, if the tuning fork sound is louder in the affected ear, it indicates conductive hearing loss. This phenomenon occurs because the conductive mechanism of the ear is impaired in such a way that external sounds are not transmitted efficiently to the inner ear. As a result, the brain perceives the sound as being louder in the affected ear, since it is less able to hear background noise or sounds from the environment that would typically compete with the sound-induced vibrations.

Conversely, in cases of sensorineural hearing loss, the sound would be heard louder in the unaffected ear because the affected ear's ability to process sound is reduced, leading to poorer hearing capabilities. Conductive losses can be due to reasons such as fluid in the middle ear, earwax buildup, or structural abnormalities, all of which interfere with sound wave transmission. Thus, hearing the tuning fork louder in the affected ear is a key characteristic of conductive hearing loss.