Clinical accuracy of tuning fork tests

A review of the literature reveals a surprisingly sparse amount of true documentation concerning the validity of using tuning forks as an adjunctive measure in the diagnosis of hearing impairment. Most reports are historical or anecdotal. With this in mind, a protocol was set up to identify the value of three standard tuning fork tests--the Rinne, the Weber, the Bing Occlusion--at frequencies of 256, 512 and 1024 Hz. The data were compared to otologic examination, audiometry and acoustic impedance. Results indicate the Rinne, Weber and Bing Occlusion tests do not accurately predict the type of hearing impairment as frequently as the literature suggests.