Rinne's Tuning Fork Test

Figure 11

Prior to carrying out the test, tell the patient what they will have to do.
In this case, they must indicate when they cease to hear the tuning fork that you have placed firmly against their mastoid process.
Furthermore, the patient should tell you when they can hear the tuning fork again when you hold it in front of the ear.
Make the tuning fork vibrate as for Weber’s test.
Place the base of the tuning fork firmly onto the patient’s mastoid process [Figure 17].

Figure 17

When the patient indicates that they are no longer able to hear the tuning fork, hold it in front of the patient’s ear.
Make sure that you hold the tuning fork so that both legs are vibrating in front of the external auditory meatus (imagine that the legs are covered by a stick and hold the middle of the tip of this imaginary stick in front of the auditory meatus) [Figure 18].

Figure 18

Rinne’s tuning fork test can also be carried out as a shortened version.
For this, you first hold the tuning fork, as described above, in front of the patient’s ear before immediately placing it on the patient’s mastoid process.
Ask the patient whether they can hear the humming of the tuning fork more loudly when the tuning fork is behind the ear, against the mastoid process, or in front of the ear.
Repeat the test for the other ear.

If the patient indicates hearing the tuning fork again when you hold it in front of their ear, or if it becomes louder in front of the ear compared to the mastoid process in the shortened version of Rinne’s test, it indicates either normal hearing or sensorineural hearing loss.
If the patient claims not to hear the tuning fork in front of the ear, or indicates hearing it as a softer tone in the shortened version of the tuning fork test, it suggests conductive hearing loss.

Rinne’s Tuning Fork Test