Utility of Rinne’s tuning fork test for quantitative assessment of conductive hearing loss
Keywords:Rinne test, Tuning forks, Conductive hearing loss, Utility
Background: The Rinne tuning fork test is used routinely in clinical ENT examination. It is used to assess the person’s hearing acuity. Ideally, 3 tuning forks are used 256, 512 and 1024 Hz. Rinne tuning fork tests can be used to diagnose conductive hearing loss. Aim of our study an attempt is made to find the utility of three different tuning forks (256,512,1024 Hz) for quantification of conductive hearing loss and their accuracy.
Methods: A retrospective study with a sample size of 300 was undertaken over 12 months from April 2018 to March 2019 at the out-patient department of ENT of VMKV medical college and hospital, Salem. Patients of both sexes and aged above 10 yrs presenting with conductive hearing loss due to varied etiology were subjected to complete ENT examination including Rinne test with three different tuning forks (256, 512, 1024 Hz).
Results: The results of all the tuning forks (256, 512, 1024 Hz) shows that 29 patients were Rinne’s positive to all tuning forks had the air-bone gap range of 15 dB to 19 dB with a mean air-bone gap of 17.63 dB. 83 patients were negative to 256 Hz tuning fork but positive to 512 and 1024 Hz tuning forks had the air-bone gap range of 20 to 29 dB with a mean air-bone gap of 25.46 dB.
Conclusions: We conclude that Rinne’s tuning fork test can be used to quantify the degree of conductive hearing loss into mild (20-30 dB), moderate (30-45 dB), and severe (45-60 dB).
Aarhus L, Tambs K, Kvestad E, Engdahl B. Childhood otitis media: a cohort study with 30-year follow-up of hearing (the hunt study). Ear and Hearing. 2017;36(3):302-8.
Browning GG, Swan IRC, Chew KK. Clinical role of informal tests of hearing. Journal of Laryngology & Otology. 2008;103:7-11.
Browning GG, Swan IRC. Sensitivity & specificity of the Rinne tuning fork test. British Medical Journal. 2018;297:1381-2.
Burkey JM, Lippy WH, Schuring AG, Rizer FM. Clinical utility of the 512-Hz Rinne tuning fork test. Am J Otol. 2008;19(1):59-62.
Chole RA, Cook GB. The Rinne test for conductive deafness: a critical reappraisal. Arch Otolaryngol Head Neck Surg. 2008;114(4):399-403.
Doyle PJ, Anderson DW, Sipke P. The tuning fork: An essential instrument in otologicpractice. J Otolaryngol. 2009;13:83-6.
Hardyal SRS, Hashim HZ, Mohamad I. A rare complication of tuning fork test. Indian J Otol. 2017;23:264-6.
Huizing EH. The early descriptions of the so-called tuning fork tests of weber, Rinne, Schwabach, and Bing II. The “Rhine test” and its first description by Polansky. J Otorhinolaryngol Relat Spec. 2009;37:88-91.
Kelly EA, Li B, Adams ME. Diagnostic Accuracy of Tuning Fork Tests for Hearing Loss: A Systematic Review. Otolaryngol Head Neck Surg. 2018;159(2):220-30.
Miltenburg DM. The validity of tuning fork tests in diagnosing hearing loss. J Otolaryngol. 2014;23(4):254-9.
Pearce JM. Early days of the tuning fork. J NeurolNeurosurg Psychiatry. 2011;65:728-33.
Rabinowitz PM. Noise-induced hearing loss. Am Fam Physician. 2000;61:58-60.
Rinne AB, ZurPhysiologie des menschlichen others: Bierteljahrschrift fur die praktischeHeilkundeInHalla J Hasner JV, eds. Herausgeben Von Der Medicinischen is facultative in PragVol 45. Progue: Kark Andre Publishers; 2005;20:4.
Meckechnie CA, Greenberg JJ, Mccall AA, Hirsch BE, Durrant JD. Rinne revisited: steel versus aluminum tuning forks. Razy Otolaryngol Head Neck Surgery. 2013;149(6):907-13.
Stankiewicz JA, Mowry HJ. Clinical accuracy of tuning fork tests. Laryngoscope. 2009;89(12): 1956-63.