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<p>Chronic otitis media (COM) is commonly associated with conductive hearing loss (CHL), which requires accurate assessment for its appropriate management. Although pure tone audiometry (PTA) is the gold standard, tuning fork tests (TFTs), such as the Rinne test, are frequently used in clinical practice. To evaluate the diagnostic accuracy of tuning fork Rinne’s tests at 256, 512, and 1024&#xa0;Hz in detecting CHL in patients with chronic otitis media, using PTA as the reference standard. This comparative cross-sectional study included 100 patients with COM who underwent PTA and tuning fork Rinne tests at 256, 512, and 1024&#xa0;Hz. PTA thresholds were classified as &lt; 25 dB HL or &gt; 26 dB HL, and air-bone gap (ABG) as &lt; 15 dB or &gt; 16 dB. The diagnostic performance (sensitivity, specificity, PPV, NPV, and accuracy) was calculated for each frequency and ear using PTA as the reference. In this study, PTA &gt; 26 dB HL was noted in 76% of right ears and 77% of left ears. ABG &gt; 16 dB was more common in the left ear (71%) than the right (58%), indicating greater conductive involvement on the left. The sensitivity of the tuning fork in Rinne’s test increased with frequency, peaking at 1024&#xa0;Hz (right, 89.47%; left, 87.01%). However, the specificity was low (0.00% at 512&#xa0;Hz and 1024&#xa0;Hz). The accuracy was highest at 1024&#xa0;Hz (right: 68.00%, left: 67.00%). The NPV remained low across all frequencies. High rates of conductive hearing loss occur in COM patients. While higher frequency Rinne’s tests (1024&#xa0;Hz best) improve diagnostic accuracy, their low specificity and NPV mean they are better as bedside screening tools in low-resource settings, needing full audiometry for definitive diagnosis. PTA provides more reliable air-bone gap measurements.</p>

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Comparing the Diagnostic Accuracy of Tuning Fork Rinne with Pure Tone Audiometry in Patients with Chronic Otitis Media – Comparative cross-sectional Study

  • 期刊论文

  • 发表日期：

    2025年9月13日

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  • Grahalakshmi Ayyadurai,
  • J. k. Prashanth,
  • C. R. K. Balaji

摘要

Chronic otitis media (COM) is commonly associated with conductive hearing loss (CHL), which requires accurate assessment for its appropriate management. Although pure tone audiometry (PTA) is the gold standard, tuning fork tests (TFTs), such as the Rinne test, are frequently used in clinical practice. To evaluate the diagnostic accuracy of tuning fork Rinne’s tests at 256, 512, and 1024 Hz in detecting CHL in patients with chronic otitis media, using PTA as the reference standard. This comparative cross-sectional study included 100 patients with COM who underwent PTA and tuning fork Rinne tests at 256, 512, and 1024 Hz. PTA thresholds were classified as < 25 dB HL or > 26 dB HL, and air-bone gap (ABG) as < 15 dB or > 16 dB. The diagnostic performance (sensitivity, specificity, PPV, NPV, and accuracy) was calculated for each frequency and ear using PTA as the reference. In this study, PTA > 26 dB HL was noted in 76% of right ears and 77% of left ears. ABG > 16 dB was more common in the left ear (71%) than the right (58%), indicating greater conductive involvement on the left. The sensitivity of the tuning fork in Rinne’s test increased with frequency, peaking at 1024 Hz (right, 89.47%; left, 87.01%). However, the specificity was low (0.00% at 512 Hz and 1024 Hz). The accuracy was highest at 1024 Hz (right: 68.00%, left: 67.00%). The NPV remained low across all frequencies. High rates of conductive hearing loss occur in COM patients. While higher frequency Rinne’s tests (1024 Hz best) improve diagnostic accuracy, their low specificity and NPV mean they are better as bedside screening tools in low-resource settings, needing full audiometry for definitive diagnosis. PTA provides more reliable air-bone gap measurements.