To the Editor.—Upon reading the excellent paper "Tuning Fork Tests in Modern Otology," by Sheehy, Gardner, and Hambley (Arch Otolaryng94:132, 1971), I was reminded of a bone-conduction test which provides the same basic information as the Weber, but which decreases the tendency to anticipate the sound in the "better" ear. It is based on the fact that a bone-conducted sound is transmitted almost equally to both cochleae, regardless of the source.
The test is performed by placing tuning forks simultaneously on both mastoids, with one fork vibrating and the other silent, but without the patient's knowing which is which. After a few seconds the forks are reversed. In asymmetrical hearing loss the sound is usually lateralized to one side regardless of the placement of the vibrating fork. Excessive volume may allow transmission by air conduction, but this is usually not misleading, and may be apparent when the