Rinne revisited

Steel versus aluminum tuning forks

Cheryl A. Mackechnie, Jesse J. Greenberg, Richard C. Gerkin, Andrew A. McCall, Barry E. Hirsch, John D. Durrant, Yael Raz

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective. (1) Determine whether tuning fork material (aluminum vs stainless steel) affects Rinne testing in the clinical assessment of conductive hearing loss (CHL). (2) Determine the relative acoustic and mechanical outputs of 512-Hz tuning forks made of aluminum and stainless steel. Study Design. Prospective, observational. Setting. Outpatient otology clinic. Subjects and Methods. Fifty subjects presenting May 2011 to May 2012 with negative or equivocal Rinne in at least 1 ear and same-day audiometry. Rinne test results using aluminum and steel forks were compared and correlated with the audiometric air-bone gap. Bench top measurements using sound-level meter, microphone, and artificial mastoid. Results. Patients with CHL were more likely to produce a negative Rinne test with a steel fork than with an aluminum fork. Logistic regression revealed that the probability of a negative Rinne reached 50% at a 19 dB air-bone gap for stainless steel versus 27 dB with aluminum. Bench top testing revealed that steel forks demonstrate, in effect, more comparable air and bone conduction efficiencies while aluminum forks have relatively lower bone conduction efficiency. Conclusion. We have found that steel tuning forks can detect a lesser air-bone gap compared to aluminum tuning forks. This is substantiated by observations of clear differences in the relative acoustic versus mechanical outputs of steel and aluminum forks, reflecting underlying inevitable differences in acoustic versus mechanical impedances of these devices, and thus efficiency of coupling sound/vibratory energy to the auditory system. These findings have clinical implications for using tuning forks to determine candidacy for stapes surgery.

Original languageEnglish (US)
Pages (from-to)907-913
Number of pages7
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume149
Issue number6
DOIs
StatePublished - 2013
Externally publishedYes

Fingerprint

Steel
Aluminum
Stainless Steel
Air
Acoustics
Bone Conduction
Conductive Hearing Loss
Bone and Bones
Stapes Surgery
Audiometry
Mastoid
Otolaryngology
Ambulatory Care Facilities
Electric Impedance
Ear
Logistic Models
Equipment and Supplies

Keywords

  • conductive hearing loss
  • otosclerosis
  • Rinne
  • tuning fork

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

Mackechnie, C. A., Greenberg, J. J., Gerkin, R. C., McCall, A. A., Hirsch, B. E., Durrant, J. D., & Raz, Y. (2013). Rinne revisited: Steel versus aluminum tuning forks. Otolaryngology - Head and Neck Surgery (United States), 149(6), 907-913. https://doi.org/10.1177/0194599813505828

Rinne revisited : Steel versus aluminum tuning forks. / Mackechnie, Cheryl A.; Greenberg, Jesse J.; Gerkin, Richard C.; McCall, Andrew A.; Hirsch, Barry E.; Durrant, John D.; Raz, Yael.

In: Otolaryngology - Head and Neck Surgery (United States), Vol. 149, No. 6, 2013, p. 907-913.

Research output: Contribution to journalArticle

Mackechnie, CA, Greenberg, JJ, Gerkin, RC, McCall, AA, Hirsch, BE, Durrant, JD & Raz, Y 2013, 'Rinne revisited: Steel versus aluminum tuning forks', Otolaryngology - Head and Neck Surgery (United States), vol. 149, no. 6, pp. 907-913. https://doi.org/10.1177/0194599813505828
Mackechnie CA, Greenberg JJ, Gerkin RC, McCall AA, Hirsch BE, Durrant JD et al. Rinne revisited: Steel versus aluminum tuning forks. Otolaryngology - Head and Neck Surgery (United States). 2013;149(6):907-913. https://doi.org/10.1177/0194599813505828
Mackechnie, Cheryl A. ; Greenberg, Jesse J. ; Gerkin, Richard C. ; McCall, Andrew A. ; Hirsch, Barry E. ; Durrant, John D. ; Raz, Yael. / Rinne revisited : Steel versus aluminum tuning forks. In: Otolaryngology - Head and Neck Surgery (United States). 2013 ; Vol. 149, No. 6. pp. 907-913.
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