Can Rinne's Test Quantify Hearing Loss?

Jacob, Vinay; Alexander, Philip; Nalinesha, K. M.; Nayar, Ravi

doi:10.1177/014556139307200211

Cited by 2 publications

(12 citation statements)

References 5 publications

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“…6 Jacob et al found that a combination of frequencies did not reliably predict the severity of CHL: among those with negative tests at 256, 512, and 1024 Hz, the average ABG values ranged from 10 to 60 dB (mean, 40 dB). 23 Similarly, Browning et al observed that the sensitivity and specificity for detecting CHL ≥20 dB did not improve with the 256- and 512-Hz Rinne tests as compared with 256-Hz Rinne test alone. 13…”

Section: Resultsmentioning

confidence: 94%

“…Equivocal results were considered abnormal 12,13,25 or excluded, 6,11,17,19,22 or their classification was not specified. 4,18,20,21,23,24,26,27 In 2 intrastudy comparisons, when equivocal data were included and considered to indicate an abnormal Rinne test result, within-study sensitivity for CHL increased by 1% to 7%, and specificity did not change ( Table 5). 17,19 Diagnostic test accuracy of Weber TFT.…”

Section: Effect Of Chl Definition and Equivocal Results On Rinne Accumentioning

confidence: 99%

“…Five studies assessed the use of TFT combinations to improve accuracy. 13,18,20,23,26 The combined results of Weber and Rinne TFTs performed in 2 studies were inconsistent. Using 512-Hz TFTs, Capper et al observed that for a child with a normal Rinne result on one side and an abnormal on the other, the Weber lateralized to the abnormal Rinne side one-third of the time.…”

Section: Resultsmentioning

confidence: 99%

“…Five studies assessed the use of TFT combinations to improve accuracy. 13,18,20,23,26 The combined results of Haapaniemi 22 ABG at intersection of cumulative distribution curves a 88 3 9 13 -Johnston 24 ABG at intersection of cumulative distribution curves a 0 100 0 -32 Capper 18 ABG at intersection of cumulative distribution curves a NR NR 0 -19 Golabek 21,b ABG at intersection of cumulative distribution curves a NR NR 0 -19 Doyle 20 Linear regression: ABG correlated with number of abnormal Mean ABG of those with equivocal responses 13.5 86.5 0 15.6 34.5 Jacob 23 Mean ABG at which .50% have abnormal Rinne 30 70 0 17.5 17.5 Crowley 19 Mean ABG at which .50% have abnormal Rinne 20 80 0 -25 Gelfand 6 Median ABG among those with abnormal Rinne Weber and Rinne TFTs performed in 2 studies were inconsistent. Using 512-Hz TFTs, Capper et al observed that for a child with a normal Rinne result on one side and an abnormal on the other, the Weber lateralized to the abnormal Rinne side one-third of the time.…”

Section: Combined Tft Effectmentioning

confidence: 99%

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Diagnostic Accuracy of Tuning Fork Tests for Hearing Loss: A Systematic Review

Kelly

Adams

2018

Otolaryngol.--head neck surg.

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Objective (1) To determine the diagnostic accuracy of tuning fork tests (TFTs; Weber and Rinne) for assessment of hearing loss as compared with standard audiometry. (2) To identify the audiometric threshold at which TFTs transition from normal to abnormal, thus indicating the presence of hearing loss. Data Sources PubMed, Ovid Medline, EMBASE, Web of Science, Cochrane, and Scopus and manual bibliographic searches. Review Methods A systematic review of studies reporting TFT accuracy was performed according to a standardized protocol. Two independent evaluators corroborated the extracted data and assessed risk of bias. Results Seventeen studies with 3158 participants, including adults and children, met inclusion criteria. The sensitivity and specificity of the Rinne test for detecting conductive hearing loss ranged from 43% to 91% and 50% to 100%, respectively, for a 256-Hz fork and from 16% to 87% and 55% to 100% for a 512-Hz fork. The audiometric thresholds at which tests transition from normal to abnormal ranged from 13 to 40 dB of conductive hearing loss for the Rinne test and from 2.5 to 4 dB of asymmetry for the Weber test. Significant heterogeneity in TFT methods and audiometric thresholds to define hearing loss precluded meta-analysis. There is high risk of bias in patient selection for a majority of the studies. Conclusion Variability exists in the reported test accuracy measurements of TFTs for clinical screening, surgical candidacy assessments, and estimation of hearing loss severity. Clinicians should remain mindful of these differences and optimize these techniques in specific clinical applications to improve TFT accuracy.

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Section: Resultsmentioning

confidence: 94%

Section: Effect Of Chl Definition and Equivocal Results On Rinne Accumentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Combined Tft Effectmentioning

confidence: 99%

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Diagnostic Accuracy of Tuning Fork Tests for Hearing Loss: A Systematic Review

Kelly

Adams

2018

Otolaryngol.--head neck surg.

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“…2,10 However, a Rinne test has limited diagnostic utility; when the ABG is <17 dB or >30 dB, the Rinne test is often normal regardless of the underlying pathology. 12 This would exclude many of the patients in our series from the benefits provided by surgery. However, a more detailed technique using both the 256-and 512-Hz tuning forks as described by Gordon et al may be more accurate in detecting small ABGs in otosclerosis.…”

Section: Discussionmentioning

confidence: 99%

Stapes Surgery in Patients with a Small Air-Bone Gap

Lavy

McClenaghan

2018

Ear Nose Throat J

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The objective of this study was to determine hearing outcomes in patients undergoing stapes surgery with a preoperative air-bone gap (ABG) <21.25 dB. Patients with a unilateral or bilateral preoperative ABG <21.25 dB undergoing primary stapes surgery were identified from a database of all stapes surgeries performed in a tertiary center over 15 years. A total of 254 ears met the inclusion criteria. The primary outcome measure was the degree of closure of the preoperative ABG. A secondary outcome measure was improvement in bone-conduction thresholds at 4 kHz. All patients underwent stapes surgery under local anesthesia. Ossicular reconstruction was achieved using a SMart 360 nitinol fluoroplastic piston (Gyrus ACMI, Inc.; South-borough, Mass.), and complete posterior crurotomy was performed with a KTP laser. Hearing was assessed with clinical voice testing immediately postoperatively and with pure-tone audiometry at 6 weeks postoperatively. A total of 248 ears (97.6%) demonstrated ABG closure to <10 dB. Bone-conduction thresholds showed an increase in 114 (44.9%), no change 74 (29.1%), and a decrease in 66 (26.0%). There is a slight increase in the risk of stapes mobilization in ears with a small ABG when compared to those with larger ABGs; however, this can be overcome by using a laser-assisted technique in combination with good surgical experience. The benefit in terms of hearing aid avoidance and the restoration of symmetrical hearing is both achievable and significant for the patient.

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Can Rinne's Test Quantify Hearing Loss?

Cited by 2 publications

References 5 publications

Diagnostic Accuracy of Tuning Fork Tests for Hearing Loss: A Systematic Review

Diagnostic Accuracy of Tuning Fork Tests for Hearing Loss: A Systematic Review

Stapes Surgery in Patients with a Small Air-Bone Gap

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