The Rinne test (
/ˈrɪnə/ rin-ə) is a hearing test.[1] It compares perception of sounds transmitted by air conduction to those transmitted by bone conduction through the mastoid. Thus, one can quickly screen for the presence of conductive hearing loss.
A Rinne test should always be accompanied by a Weber test to also detect sensorineural hearing loss and thus confirm the nature of hearing loss.
The Rinne test was named after German otologist Heinrich Adolf Rinne (1819-1868);[2][3] the Weber test was named after Ernst Heinrich Weber (1795 – 1878).
[edit] Procedure
The Rinne test is performed by placing a vibrating tuning fork (512Hz, whereas, 256 Hz is typically used for the vibratory tuning fork sound of the Weber test) against the patient's mastoid bone and ask the patient to tell you when the sound is no longer heard. Time this interval of bone conduction with a watch, noting the number of seconds. Quickly position the still vibrating tines 1-2 cm from the auditory canal, and again ask the patient to tell you when the sound is no longer heard. Continue timing the interval of sound due to air conduction heard by the patient. Compare the number of seconds sound is heard by bone conduction versus air conduction; air conducted sound should be heard twice as long as bone conducted sound (e.g., if bone-conducted sound is heard for 15 seconds, air-conducted sound should be heard for 30 seconds).
[edit] Air vs. Bone Conductive Hearing Loss
Air conduction uses the apparatus of the ear (pinna, eardrum and ossicles) to amplify and direct the sound whereas bone conduction bypasses some or all of these and allows the sound to be transmitted directly to the inner ear albeit at a reduced volume, or via the bones of the skull to the opposite ear.
| Description |
Relative |
Positive/negative |
| In a normal ear, air conduction (AC) is better than bone conduction (BC) |
AC > BC |
this is called a positive Rinne |
| In conductive hearing loss, bone conduction is better than air |
AC < BC |
negative Rinne |
| In sensorineural hearing loss, bone conduction and air conduction are both equally depreciated, maintaining the relative difference of bone and air conductions |
AC > BC |
positive Rinne |
| In sensorineural hearing loss patients there may be a false negative Rinne |
AC < BC |
negative Rinne |
Note that the words positive and negative are used in a somewhat confusing fashion here, other than their normal use in medical tests. Positive or negative means that a certain parameter that was evaluated was present or not. In this case, that parameter is if air conduction (AC) is better than bone conduction (BC). Thus, a "positive" result indicates the healthy state, in contrast to many other medical tests. Therefore, if presenting your findings to a physician, to avoid confusing yourself, it may be wise to avoid using the term 'positive' or 'negative', and simply state if the test was normal or abnormal e.g. 'Rinnes test was abnormal in the right ear, with bone conduction greater than air conduction'.
[edit] Hazards
This test and its complement, the Weber test, are quick screening tests and are no replacement for formal audiometry. Recently, its value as a screening test has been questioned.[4]
[edit] Effect on Opposite Ear
The effect on the opposite ear, relative to the tuning fork, is reverse to the ear being tested. Here, conduction through the skull to the opposite side is more effective than conduction through room air around the head. Thus, if the normal ear is not masked[clarification needed], bone conduction could be reported as louder by the patient, even if both ears are normal[clarification needed].
[edit] References
[edit] External links
/ˈrɪnə/ rin-ə) is a hearing test.[1] It compares perception of sounds transmitted by air conduction to those transmitted by bone conduction through the mastoid. Thus, one can quickly screen for the presence of conductive hearing loss.
