Family Nurse Practitioner Exam

What result is expected on a Rinne test for a patient with conductive hearing loss?

1. AC > BC

2. Lateralization to the bad ear

3. BC > AC

4. Lateralization to the good ear

The correct answer is: BC > AC

In the context of the Rinne test, which compares air conduction (AC) and bone conduction (BC) of sound, a result indicating conductive hearing loss would show BC greater than AC. This occurs because the sound transmission through the bones of the skull is less affected than through the air in cases of conductive hearing loss. The underlying mechanism is that in conductive hearing loss, there is an obstruction or dysfunction in the outer or middle ear that hampers sound waves from being effectively transmitted through air, making the bone conduction sound appear louder than air conduction. In a patient with conductive hearing loss, the expected finding of BC greater than AC reflects this principle, as the effectively conducted sound is perceived better through bone conduction when an air conduction pathway is compromised. This fundamental understanding of sound conduction is crucial for differentiating hearing loss types during clinical assessments.