Signs
 

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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