A new modification of the Rinne test

A modification of Rinne's test is described. The result of the test is dependent on many factors and in particular the force with which the tuning fork is applied to the mastoid process is important. Most authorities state that firm pressure should be used but the precise force required is inadequately defined. A modification of a standard tuning fork was therefore designed which allows measurement of the actual force used. 100 ears with confirmed conductive hearing losses were examined. Rinne's test was performed on each ear comparing three different forces. The forces used were 400 g (3.9 N) corresponding to light pressure, 2400 g (23.5 N) corresponding to firm pressure, and an intermediate and indeterminate force corresponding to normal clinical performance of the test. The optimum force in this study is 2400 g (23.5 N) force. This gives increased sensitivity, specificity and accuracy compared to lesser forces. More accurate measurement of the force used allows better reproducibility and more meaningful comparison of the results thus obtained.