Rinne Test - Air Vs. Bone Conductive Hearing Loss

Air Vs. Bone Conductive Hearing Loss

Air conduction uses the apparatus of the ear (pinna, eardrum and ossicles) to amplify and direct the sound whereas bone conduction bypasses some or all of these and allows the sound to be transmitted directly to the inner ear albeit at a reduced volume, or via the bones of the skull to the opposite ear.

Description Relative Positive/negative
In a normal ear, air conduction (AC) is better than bone conduction (BC) AC > BC this is called a positive Rinne
In conductive hearing loss, bone conduction is better than air AC < BC negative Rinne
In sensorineural hearing loss, bone conduction and air conduction are both equally depreciated, maintaining the relative difference of bone and air conductions AC > BC positive Rinne
In sensorineural hearing loss patients there may be a false negative Rinne AC < BC negative Rinne

Note that the words positive and negative are used in a somewhat confusing fashion here, other than their normal use in medical tests. Positive or negative means that a certain parameter that was evaluated was present or not. In this case, that parameter is if air conduction (AC) is better than bone conduction (BC). Thus, a "positive" result indicates the healthy state, in contrast to many other medical tests. Therefore, if presenting your findings to a physician, to avoid confusing yourself, it may be wise to avoid using the term 'positive' or 'negative', and simply state if the test was normal or abnormal e.g. 'Rinnes test was abnormal in the right ear, with bone conduction greater than air conduction'.

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