![]() Sensitivity of the 512-Hz Rinne tuning fork test was assessed by comparing tuning fork results with the pure-tone average air-bone gap. The effects of tester experience, the use of masking, and the interpretation of equivocal (+/-) Rinne results on test reliability also were examined.ġ,000 adult patients (2,000 ears) seen for their initial otologic evaluation. On testing bone conduction on the right the sound travels to the good left (i.e.This study aimed to examine the reliability of the 512-Hz Rinne tuning fork test to detect conductive hearing losses. ![]() For example, imagine the right ear is ‘dead’.The difficulty in interpreting Rinne’s test is in total unilateral sensorineural hearing loss (i.e. ![]() 2) If the patient can hear best when the tuning fork is on the mastoid (negative Rinne’s) bone conduction is better than than air conduction, demonstrating a conductive hearing loss.Therefore in sensorineural hearing loss on the right, for example, Rinne’s test should be positive on the right.1) If a patient can hear best when the tuning fork is in the air (positive Rinne’s) then air conduction is better than bone conduction so there is no significant conductive hearing loss.In a normal ear sound is conducted to the cochlear most efficiently via air conduction. Sound can also be transmitted to the cochlea, less efficiently, via bone.A patient who hears the fork loudest when it is held against the mastoid process has a negative Rinne’s test.A patient who hears the tuning fork loudest when held 1cm from the external auditory meatus has a positive Rinne’s test.What is a positive and negative Rinne’s Test? Ask the patient in which of the positions they were able to hear the note the loudest in.Leave it there again for a few seconds before taking the tuning fork away from their ear.Then promptly lift the fork off the mastoid process and place the vibrating tips about 1cm from their external auditory meatus.Allow it to stay there for 2-3 seconds to allow them to appreciate the intensity of the sound.Hold the tuning fork in one hand and place the base against the patient’s mastoid process ( see video).Begin by striking the tuning fork against your knee or elbow.I want you to tell me which position you hear the tuning fork loudest in” “I’m going to put this vibrating tuning fork in two positions, one touching the bone near you ear, one a short distance from the ear.Rinne’s test can only detect a conductive hearing loss of at least 30dB.Rinne’s test has a high sensitivity (0.84) though this varies with the skill of the examiner.This test aims compare air conduction with bone conduction. ![]() Interpretation of Rinne’s and Weber’s tests Test
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