Rinne Test Results: How Badly Can We Be Mistaken?

Objective To establish the extent to which sound amplitudes delivered by a vibrating tuning fork change around its long axis and to evaluate whether such differences in amplitude might change the results of the Rinne test. Study Design Experimental measurements. Setting Laboratory setting. Methods S...

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Bibliographic Details
Published in:OTO open : the official open access journal of the American Academy of Otolaryngology--Head and Neck Surgery Foundation 2021-01, Vol.5 (1), p.2473974X21996998-n/a
Main Authors: Wrobel, Maciej J., Bogacz, Bogdan F.
Format: Article
Language:English
Subjects:
Accuracy
air conduction
bone conduction
Diagnostic tests
Hearing loss
Medical screening
Original Research
Rinne test
Sound
tuning fork
Vibration
Citations: Items that this one cites
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Summary:Objective To establish the extent to which sound amplitudes delivered by a vibrating tuning fork change around its long axis and to evaluate whether such differences in amplitude might change the results of the Rinne test. Study Design Experimental measurements. Setting Laboratory setting. Methods Setup I: a vibrating tuning fork was handheld and manually rotated around its long axis next to a sound recording device (the simulated ear) in order to record sound amplitude data at a full range of angles relative to the device; files were split into segments in which sound amplitude changed: A (from a maximum to a minimum) and B (from a minimum to a maximum). Setup II: a vibrating tuning fork was machine-rotated, and the angle of rotation, along with the sound amplitude, was automatically recorded through a single full rotation. Results The angles of 0° and 180° (which equate to the established best practice in Rinne testing) were associated with the highest sound amplitudes. All other angles decreased sound amplitude. The greatest decrease in amplitude was recorded at 51° and 130°. This difference ranged from 9.8 to 34.7 dB, depending on the initial amplitude. Conclusion The outcome of a Rinne test can be affected if attention is not paid to the precise angle at which the tuning fork is held relative to the ear. The potential of this effect will be greater when high background noise or patient hearing loss requires that the tuning fork be vigorously excited to obtain high sound amplitudes.
ISSN:2473-974X
2473-974X
DOI:10.1177/2473974X21996998