What would the Weber test indicate in a patient with cerumen impaction in the left ear?

In a patient with cerumen impaction in the left ear, the Weber test would typically indicate lateralization to the left. The Weber test is used to assess hearing lateralization by placing a vibrating tuning fork in the center of the forehead or the skull. Normal hearing would not demonstrate lateralization, but when there is a conductive hearing loss, such as that caused by cerumen impaction, the sound will lateralize to the affected ear. This is because the occlusion decreases the ability of sound to travel through the air (air conduction), leading the bone conduction to become more prominent, which is detected in the ear with the obstruction.

Specifically, since the cerumen impaction is in the left ear, the patient would perceive the sound as louder in that ear during the test, thus indicating lateralization to the left. In contrast, if the hearing loss were sensorineural rather than conductive, the test would lateralize to the good ear. Understanding the mechanisms of this test is crucial for interpreting the results correctly in clinical scenarios involving hearing impairments caused by various factors.