Negative Rinne’s test for 256 Hz tuning fork indicates a minimum air-bone gap of 15dB.The most preferred and commonly used is 512 Hz frequency tuning fork because it is better felt.Frequency of tuning fork commonly used for performing Rinne’s test is 512Hz.Tuning fork tests used to differentiate hearing loss are:Rinne’s test,Weber test,Absolute bone conduction (ABC) test,Schwabach’s test,Bing test,Gelle’s test.Weber’s test best elicited by placing tuning fork on the middle of the patient’s forehead and he is asked to say in which ear he hears the sound better.Sensorineural hearing loss:Positive test result (Decreased hearing).Conductive hearing loss:Negative test result(Normal hearing).Normal:Positive test result(Decreased hearing).Tuning fork is placed on mastoid and the pressure in the ear canal is increased using the Siegle’s speculum.Conductive Hearing Loss:No change in hearing(Negative).Sensorineual Hearing loss:hears louder when ear canal is open(Positive).Normal: Hears louder when ear canal is closed (Positive).This is like ABC test, but the external ear canal is alternately closed and opened by pressing and releasing the tragus.Conductive loss:Bone Conduction is equal to that of examiner.Sensorineural loss:Bone Conduction is reduced as compared to Examiner’s.This is a modified Schwabach’s test where, the bone conduction level of patient is compared to that of the clinician with inclusion occlusion of the External Auditory Canal(assuming that Examiner has Normal Hearing).Conductive loss.If the patient hears it longer than the examiner.Sensorineural loss:If the patient stops hearing before the examiner.Normal:Patient’s Bone Conduction is equal to that of examiner.It compares the patient’s bone conduction to that of the examiner’s(assuming that Examiner has Normal Hearing).Sensorineural deafness – He hears better in the normal ear.Conductive deafness – He hears the sound better in the diseased ear.Normal – He hears the sound equally in both ears.Weber’s test best elicited by placing tuning fork on the middle of the patient’s forehead and he is asked to say in which ear he hears the sound better. ![]() The above can also be avoided by giving a masking sound to the non-test ear.
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