Rinne Test
If you have a patient consulting you about hearing loss in one of their ears, one of the tests you can conduct is the Rinne Test to determine if the patient is dealing with conductive or sensorineural hearing loss.
Fact Checked by Nate Lacson.
What is the Rinne Test?
The is an otological clinical assessment developed by and named after Heinrich Adolph Rinne over a century ago. This test was designed to gauge a patient’s hearing loss using a tuning fork to see if the hearing loss is conductive or sensorineural. It is one of the most reliable otological assessments and is one of the two remaining tuning fork hearing assessments still being used today, the other being the Weber Test.
This test assesses the type of hearing loss patients have by checking whether the air conduction of the fork is greater than the bone conduction and vice-versa! A sign of conductive hearing loss is that the bone conduction of the test is greater than the air conduction. This means that the sound is heard in the affected ear, which indicates a problem related to the outer and/or middle ear.
On the other hand, if the air conduction is greater than the bone conduction, but the sounds for both are depreciated, the hearing loss is sensorineural. This means the affected ear has a problem with the inner ear or auditory nerve.
This test should only be conducted by audiologists and ENTs (Ear, Nose, and Throat doctors) since they are knowledgeable about the ear’s anatomy and know how to properly conduct this test and interpret the findings.
Printable Rinne Test
Download this Rinne Test to determine if the patient is dealing with conductive or sensorineural hearing loss.
How to conduct the Rinne Test
Before you conduct the Rinne Test, there are two essential things tat you need to prepare. The first one is a silent room to serve as the venue of the test. It doesn’t have to be big! So long as it fits both you and the patient, it should work. The reason why it has to be a silent room is that other sounds might interfere with the test and affect the hearing and attention of your patient. They need to focus on the sound coming from the second thing you need for this test: a tuning fork.
The tuning fork is essential to this test because it will determine the type of hearing loss the patient has. The tuning fork must have a frequency of 512-hz because it has a good balance of tone decay and tactile vibration.
Once you have both of these prepared, you can follow these instructions:
- Have your patient sit on a chair.
- Strike the tuning fork on your elbow or knee to activate it. Don’t strike it on a hard object or surface because doing so might damage it and affect the test.
- As soon as you activate the tuning fork, move it and place it firmly on the patient’s mastoid process. This is the bone conduction part of the test.
- Ask the patient if they hear the sound from the vibrating tuning fork. Tell them to let you know if they no longer hear the sound.
- As soon as the patient tells you they no longer hear the sound, quickly move the vibrating tuning fork from the mastoid process to the entrance of the ear canal. The fork should not touch the ear. This is the air conduction part of the test.
- Ask the patient if they hear the sound again. Then, tell them to let you know when they stop hearing the sound.
The test results will depend on how long they heard each sound during both the bone conduction and air conduction phases of the test.
If the length of time they heard the sound is longer during the air conduction phase than during the bone conduction phase, plus they heard it clearly, then the test is positive, and the hearing is normal.
If the length of time they heard the sound is longer during the bone conduction phase than during the air conduction phase, the test is negative and indicates that the patient is dealing with conductive hearing loss. The next step is to conduct a comprehensive examination to confirm the results to help determine what you need to do for the patient.
If the length of time they heard the sound is longer during the air conduction phase than during the bone conduction phase, but both sounds are equally depreciated, then the test is a false positive. This indicates that the patient has sensorineural hearing loss. You should also conduct a comprehensive examination if this is the result.
If they don’t hear anything at all with their affected ear, then the test is a false negative. This means that the hearing loss is significant. As with the others, a comprehensive examination should be conducted after.
Rinne Test Example
Normally, the Rinne Test doesn’t have a sheet where you put down your findings. We at Carepatron took the liberty of remedying that by creating a Rinne Test PDF template! Our template contains the instructions on how to do the test (just as a refresher!), tickboxes to make your designation for your patient after conducting the test, and an additional comments box where you can discuss your findings and explain any reasonings you may have regarding any decisions you’ll make for your patient moving forward.
If you like what you see and believe this is a good way to keep a record of your test results, then feel free to download it from our platform! It’s free. You can print it and fill it out with a pen, or you can go paperless and just engage with the Rinne Test PDF template’s editable components!
Download this Rinne Test Example (Sample) here:
When is it best to conduct the Rinne Test?
If you have a patient that scheduled an appointment with you to discuss hearing loss, and when they turn up for the appointment, they mention a reduction or muffling in their hearing for either or both ears, then that is the best time to conduct the Rinne Test. Though, before you conduct the test, you need to explain what the test is and what it’s for. Just like any procedure, you need to get their consent first, and their decision should be respected. If they are fine with the explanation of the test and want to take it, then by all means, conduct it.
The Rinne Test is also conducted alongside the Weber Test, which is the other tuning fork hearing assessment that’s still being used today. If you are interested in the Weber Test or if you already know about it, we’d like you to know that we also have a guide for it as well as a template! Since you’re reading this, you’re likely to be an otologist/audiologist, so you’re aware that the Weber Test can help give you a better picture of the patient’s hearing loss if used with the Rinne Test. We recommend you download our template for that as well so you can record your findings.
Also, since we mentioned getting a “better picture of a patient’s hearing loss,” you can do so by conducting a comprehensive examination that involves other tests besides this one and the Weber Test. There are other audiological examinations that you might want to use, like Tympanometry, which is a test that tries to check how well the middle ear is working. That way, you can cover as much ground as you can before you determine what to do for your patient.
Who can conduct the Rinne Test?
The Rinne Test is a hearing loss assessment, so the obvious answer is that it should be conducted ONLY by healthcare professionals who have a proper understanding of the ear anatomy, the function of each part, how to analyze and assess ear-related issues, and how to treat such issues. These healthcare professionals include the following:
- Audiologists - These professionals specialize in dealing with anything related to the ears and are highly trained in assessing hearing and balance disorders, plus, they are also knowledgeable when it comes to finding ways to manage or work around ear-related afflictions. This means they have a grasp on examinations like the Rinne Test.
- ENTs (Ontologists) - Ear, Nose, and Throat doctors are also knowledgeable when it comes to conducting audiological examinations and how to treat ear-related ailments. Not only that, but they also know the necessary medication that can be prescribed to patients (if ever they are able to determine that medicine can help) and perform surgical procedures that could fix ears (otoplasty).
- Hearing Instrument Specialists - These professionals may not have prescribed medicine and conducted surgery in their scope of work, but they are normally trained in conducting hearing loss assessments like the Rinne Test and Weber Test, so you can trust them to do those. They are also the ones who will be dispensing and fitting patients with hearing aids, so if being given a hearing aid is part of the decisions by their team, they will be responsible for providing the aid to the patient.
It is best to leave this test to the aforementioned professionals because they know how to properly conduct and accurately interpret the findings of the Rinne Test.
Why use Carepatron for ENT-related work?
If you are an ENT, an Audiologist, or an adjacent healthcare professional, we’d like you to check out our platform! Take your time to browse through it. We’re sure you’re bound to find something cool that you might find beneficial for your work.
One of the features that we are most proud of is our treasure trove of clinical resources. It’s filled to the brim with worksheets, assessments (including the Rinne Test), general treatment plans, progress note templates, survey templates, form templates, and more! It even covers numerous healthcare fields, including audiology and ENT-related work.
We also have numerous guides, just in case you need to refresh yourself with some tests related to your work, like the Weber Test! Our guides come with templates, so read and download as much as you want and need for free!
If you subscribe to our platform, you’ll gain access to our nifty storage system, allowing you to store your clinical documents with us in a HIPAA-compliant manner! It’s super secure that, even if you’re storing them with us, we can’t access them because only you can determine who can access them besides you! We recommend subscribing to our platform as a team so you can access one storage, store your files, and share results easily!
Storing your files with us is the same as creating electronic backups of them. Just in case you lose your physical files somehow, like, because of a fire (hopefully, this doesn’t happen, of course). You can re-download them from the storage and reprint them!
We at Carepatron are committed to helping healthcare professionals with their work, so take advantage of our platform so we can find ways to streamline your workflows and help you preserve your work!
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Commonly asked questions
No. It can only determine what type of hearing loss the patient has and in turn, determine which part of the ear is related to the hearing loss. That’s why this and the Weber Test are used as part of a comprehensive examination. Other tests should be able to determine the cause, but the direction for these tests will be set by what type of hearing loss the patient has.
Sadly, that is not a good sign because that means they are likely to have significant hearing loss in the ear. You should check first if there is earwax or fluid blockage. If their ears are clean, it’s best to conduct further examination to determine why the hearing loss is significant.
The answer is no to both questions. The Rinne Test is a non-invasive exam. The tuning fork will not be used to dig into the skin, nor will it be placed inside the ear of the patient. It’s a test that relies on the sound produced by the tuning fork, and all the patient and the healthcare professional need to do is check if the patient can hear the sounds.
