A patient with sudden one-sided hearing loss and a normal-looking ear canal and drum needs sudden sensorineural hearing loss excluded, because treatment is time-sensitive. A 512 Hz tuning fork helps: in sensorineural loss, the Weber test lateralises to the better ear; in conductive loss, it lateralises to the affected ear.
Wax or effusion are common and benign causes of conductive loss. A sensorineural pattern should prompt same-week audiometry and specialist assessment.
- Examine the ear canal and drum first.
- Weber lateralising to the good ear suggests sensorineural loss.
- Weber lateralising to the affected ear suggests conductive loss.
- Arrange urgent audiometry and ENT review for suspected sensorineural loss.
Why it matters
Sudden sensorineural hearing loss is easy to dismiss as wax or a cold, and delay narrows the treatment window.
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