Tunning Forks Hearing Tests

The single most common office test is a tuning fork test called the Rinne, named after Adolf
Rinne of Gottingen, who described this test in 1855. In the Rinne test, a comparison is made
between hearing elicited by placing the base of a tuning fork applied to the mastoid area
(bone), and then after the sound is no longer appreciated, the vibrating top is placed one inch
from the external ear canal (air). A positive Rinne indicate an air-bone gap and, therefore,
presumed presence of a conductive hearing loss.
In the Weber test, a 512 Hz tuning fork is placed on the patient's forehead. If the sound
lateralizes (is louder on one side than the other), the patient may have either an ipsilateral
conductive hearing loss or a contralateral sensorineural hearing loss. If the sound is heard
best in the affected ear, it suggests conductive hearing loss; if heard best in the normal ear, it
suggests sensorineural hearing loss.
At the case of chronic otitis media at the left ear, the sound is heard best in the affected ear,
the left one. This is caused by the air conduction-masking. At the right ear-the normal one,
the bone conduction is masked by the air conduction results the reduction of the bone
conduction. On the other hand, at the left ear, the air conduction has been impaired by the
infection, then hearing process just comes from the bone conduction, without any masking.
Other tuning fork test, the Schwabach test compares the patient's bone conduction to that of
the examiner's. If the patient stops hearing before the examiner, this suggests a sensorineural
loss. If the patient hears it longer than the examiner, this suggests a conductive loss. Of
course, this test is contingent on the examiner having normal hearing.

At the case of chronic otitis media of the left ear, the results of the tests are:
-

The positive Rinne test at the left ear

The lateralization to the left ear of the Weber Test

A longer Schwabach test of the left ear.