Final answer:
After a positive Weber test, a patient should undergo the Rinne test (option 2) to determine whether they have conductive or sensorineural hearing loss. The Rinne test involves comparing the patient's ability to hear vibrations through bone conduction versus air conduction.
Step-by-step explanation:
When a patient has a positive Weber test, indicating a potential unilateral hearing loss, the next step in assessing the type of hearing loss is often to perform the Rinne test. The Weber test uses a tuning fork to test the laterality of hearing loss by placing it at several locations on the midline of the skull. If an abnormality is detected—as in a positive Weber test—the Rinne test then helps to distinguish between conductive hearing loss and sensorineural hearing loss.
In the Rinne test, a vibrating tuning fork is placed on the mastoid process, and the patient is asked to signal when the sound is no longer heard. The tuning fork is then quickly moved next to the external ear canal to test if the sound can be heard through air conduction. In a patient with conductive hearing loss, sound conducted through the bone (mastoid process) would be louder than sound through air (next to the ear canal), whereas a person with normal hearing or sensorineural hearing loss would hear the sound louder through air conduction.
Therefore, if the Weber test is positive, suggesting a hearing loss on one side, the patient should undergo the Rinne test to further clarify the type of hearing loss before more comprehensive tests such as pure tone audiometry or tympanometry are considered.