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Rinne’s Test

 
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Overview

Rinne's test is used to assess a patient with hearing impairment, and compares sound heard through the ears with sound conducted via the mastoid process in order to determine the type of hearing loss present.
  • How to Elicit

  • Place a 256hz tuning fork onto the patient's mastoid process. Ask them to indicate when they can no longer hear the vibration.
Once the patient can no longer feel the vibration, move the tuning fork in from of the auditory meatus and ask them whether they can still hear the sound.
  • Interpretation

  • Louder via the auditory meatus - normal / sensorineural hearing loss (Rinne positive)
  • Louder via the mastoid - conductive hearing loss (Rinne negative)
  • Causes of Hearing Loss

  • Conductive

  • External auditory canal - wax, foreign body, tumour, otitis externa
  • Middle ear - perforated eardrum, otitis media, otosclerosis
  • Sensorineural

  • Presbycusis (age-related hearing loss)
  • Trauma - noise trauma
  • Inflammation - meningitis, encephalitis, SLE, giant cell arteritis
  • Ototoxicity - gentamicin, frusemide, cisplatin, aspirin
  • Tumour - acoustic neuroma, meningioma, SCC, metastasis
  • Idiopathic - Meniere’s disease
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