In normal hearing, air conduction is better than bone conduction. The tuning fork is heard more clearly when placed in line with the external auditory meatus than when placed on the mastoid process. The result is termed Rinne's positive, or alternatively, may be written as AC > BC.
In the presence of a conductive hearing loss, bone conduction is heard more clearly than air. The result is described as Rinne's negative or may be written BC > AC. It requires a conductive hearing loss of at least 20 decibels.
A Rinne's negative may be:
A false Rinne's negative should always be considered in:
To avoid false Rinne's negatives, it is best to "mask" the good ear whilst the suspect ear is being tested, and to always follow the Rinne's test with a Weber's test. The simplest method of masking the non-test ear is to massage the tragus; alternatively, a Barany noise box may be used.
Last reviewed 01/2018