patient receiving a rinne test

Rinne Test: What It Is and What It Means for Your Hearing

What is a Rinne Test?

The Rinne test is commonly recommended to determine if an individual has hearing loss in one ear (unilateral hearing loss). The test compares the two different ways that the ear receives sound from our environment. It is used to test for hearing loss by comparing perception of sounds transmitted by air conduction to those transmitted by bone conduction through the mastoid bone.

The Rinne test should always be performed in conjunction with a Weber test in order to help distinguish between conductive hearing loss and sensorineural hearing loss.


How is a Rinne test conducted?

The test is conducted by a medical professional using a 512 Hz tuning fork in a quiet room.

  • The doctor will lightly strike the tuning fork, causing it to vibrate. 
  • The tuning fork will then be placed on the mastoid bone behind the ear. 
  • The patient will verbally indicate when sound is no longer heard. 
  • The doctor will then place the fork beside the ear and ask if it is still audible. 

If a patient is experiencing conductive hearing loss, they will not hear the tuning fork when it is placed beside the ear because air conduction is greater than bone conduction in normal hearing. This is abnormal and is known as Rinne negative

*In some patients with otosclerosis, the test is performed to determine if the patient is eligible for stapes surgery.


What type of conductive hearing loss can the Rinne test uncover?

  • Wax in the external canal
  • Foreign body in the ear canal
  • Perforation of the drum 
  • Infection (acute otitis media) 
  • Abnormal Bone Growth (Otosclerosis) 

Is a Rinne test accurate?

The Rinne test does not replace a formal audiometry test. It should be used as a screening and indicator of what steps your medical professional should take next to more accurately diagnose your hearing loss. 

The validity of the test is sometimes questioned because it is not sensitive in differentiating conductive hearing loss and sensorineural loss of total sensorineural or severe unilateral hearing loss. If there is ever any question about the validity of the Rinne test, the patient should visit an ear, nose and throat surgeon (ENT or Otolaryngologist) for additional comprehensive testing. 

Another important fact to remember is that the techniques used for Rinne tests are not all uniform. The orientation of the tuning fork and its exact placement vary from physician to physician. All physicians who perform the Rinne test must pay close attention to the tines of the tuning fork and how they are oriented on both the mastoid bone and when placed near the ear.

As previously mentioned, the Rinne test should be used in conjunction with the Weber test and should only act as an initial screening. This does not replace formal audiometry conducted by your doctor.

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