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Rinne test

Procedure: - a vibrating tuning fork (> 500 Hz) is placed on the mastoid process - when the perceived sound subsides, the fork is placed close to the ear canal, without restriking. Interpretation: - normally, the sound can be heard via air conduction for twice as long as via bone conduction (+ Rinne test) - with conductive hearing loss, the ratio becomes closer to 1:1, or less but ONLY when conductive hearing loss becomes moderate, not mild (- Rinne test) [3] - with mild conductive hearing loss* or sensorineural hearing loss, the ratio of air conduction to bone conduction remains normal at 2:1. (+ Rinne test)* * the most likely cause of conductive hearing loss in nursing home residents is cerumen impactation & the conductive hearing loss is mild [3] * audiogram interpretation of the air conduction/bone conduction ratio differs from the Rinne test such that with sensorineural hearing loss both air conduction & bone conduction are equally depressed at the same point on the audiogram [4]

Related

hearing loss (hearing impairment, hard of hearing, HOH)

General

hearing evaluation

References

  1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 43, 1071
  2. Guide to Physical Examination & History Taking, 6th edition, Bates B, JB Lippincott, Philadelphia, 1995, pg 182
  3. NEJM Knowledge+ Otolaryngology
  4. Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022