Clinical Assessment: Rinne Test
Use a 512 Hz tuning fork to compare air and bone conduction in each ear. Perform alongside the Weber test and otoscopy for a complete hearing assessment.
Rinne Test
A clinical tuning-fork test comparing air conduction (AC) with bone conduction (BC) to distinguish conductive from sensorineural hearing loss. Named after Heinrich Adolf Rinne (1855).
Administration protocol:
- Strike a 512 Hz tuning fork and place the base firmly on the patient's mastoid process (bone conduction). Ask the patient to signal when they no longer hear the sound.
- Immediately move the still-vibrating fork 1–2 cm from the ear canal opening (air conduction) and ask if the patient can still hear it.
- Record findings for each ear separately.
Interpretation reference
Rinne Positive (AC > BC)
Air conduction (AC) heard longer than bone conduction (BC) when the tuning fork moves from mastoid to ear.
Normal hearing or sensorineural hearing loss. Air conduction remains better than bone conduction in sensorineural loss.
If hearing loss present with AC > BC, pursue audiogram and audiology referral. Not conductive hearing loss.
Rinne Negative (BC ≥ AC)
Bone conduction heard as long as or longer than air conduction.
Suggests conductive hearing loss in the tested ear (e.g. cerumen impaction, otitis media, ossicular chain dysfunction).
Notify provider. Otoscopy to assess for obstruction or effusion. Audiological and otolaryngology referral.