Where to place the tuning fork during a Weber or Rinne test?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: May 29, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

The Rydel Seiffer tuning fork should be placed at the midline of the forehead or on the maxillary teeth during examination. This is based on the most recent and highest quality study available, which provides guidelines for the proper technique for Weber and Rinne testing 1. When performing the Weber test, it is essential to vibrate the tuning fork by striking it on a covered elbow or knee, not on a hard metallic or wooden surface, to avoid nonharmonic frequencies. The tuning fork should then be placed at the midline of the forehead or on the maxillary teeth, and the patient should be asked to report where they hear the sound.

  • The sound is normally heard at the midline or "everywhere" 1.
  • If the sound lateralizes to one ear, it may indicate conductive hearing loss (CHL) in that ear or sensorineural hearing loss (SNHL) in the opposite ear 1.
  • The Rinne test can also be used in conjunction with the Weber test to help distinguish between CHL and SNHL, by placing the vibrating tuning fork over the mastoid bone of one ear and then moving it to the entrance of the ear canal 1. It is crucial to note that tuning fork tests, while useful for initial assessment, do not replace formal audiometric testing, which is necessary for an accurate diagnosis of hearing loss 1.

From the Research

Placement of Rydel Seiffer Tuning Fork

  • The Rydel-Seiffer tuning fork is used to evaluate vibration sensation and identify patients at risk of foot injury due to loss of vibration sensation 2.
  • The optimal placement of the Rydel-Seiffer tuning fork during examination is not explicitly stated in the provided studies.
  • However, studies suggest that the tuning fork can be used to assess vibration sensation in various parts of the body, including the feet 2 and to evaluate pallesthesia in subjects with peripheral neuropathy 3.
  • The Rydel-Seiffer tuning fork has been shown to be a useful tool for assessing potential nerve conduction deficits in the evaluation of pallesthesia 3.

Related Studies on Bone Conduction

  • Studies on bone conduction mechanisms suggest that vibrations from a bone vibrator can induce audio-frequency sound pressures in the skull contents, which are then communicated to the inner ear fluids 4, 5.
  • These studies do not provide direct evidence on the placement of the Rydel-Seiffer tuning fork, but they do provide insight into the mechanisms of bone conduction and vibration sensation.
  • The use of bone conduction devices has been shown to be beneficial in patients with conductive hearing loss, and the proper placement of these devices is crucial for effective binaural hearing 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

The tuning fork revisited.

Diabetic medicine : a journal of the British Diabetic Association, 1990

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.