Re - evaluation of Rinne test with aluminum alloy tuning fork 256 Hz and 512 Hz

Abstract

© 2019 Siriraj Medical Journal. Objective: To study the sensitivity, specificity and accuracy of the 256 Hz and 512 Hz aluminum tuning fork in the detection of conductive hearing loss by quick Rinne test. Methods: The patients with hearing problems recruited from out-patient unit were tested with the 256 Hz and 512 Hz aluminum quick Rinne test. The audiometry was performed on the same day and the results were compared. Results: During the study period, 246 ears with conductive hearing loss and 246 ears with non-conductive hearing loss were recruited. The 256 Hz Rinne test had higher sensitivity than the 512 Hz Rinne test (93.83% and 71.95% respectively). The specificity and accuracy of the 512 Hz Rinne test was markedly greater than the 256 Hz Rinne test (91.18 % vs. 26.7% specificity and 83.57% vs. 61.85% accuracy). The 512 Hz Rinne test had sensitivity over 80% when the air-bone gap was equal to or greater than 20 dB. The sensitivity was even higher (more than 90%) if the air-bone gap was equal to or greater than 30 dB. Conclusion: This study demonstrated that the 512 Hz Rinne test had better accuracy than the 256 Hz Rinne test for the diagnosis of conductive hearing loss. The 512 Hz Rinne test can detect the air-bone gap of 30 dB or greater which indicates the surgical role with the sensitivity more than 90%. We recommend that 512 Hz Rinne test should be used as a screening tool for the detection of conductive hearing loss.