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Examination Stations
Published in Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar, ENT OSCEs, 2023
Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar
This tests the bone conduction. Next, place the tuning fork in front of the test ear with the tuning fork's tines perpendicular to the head, hence testing air conduction. Ask the patient which one he or she heard loudest and take note of the result.
Hearing Tests
Published in Raymond W Clarke, Diseases of the Ear, Nose & Throat in Children, 2023
Bone-conduction testing is now performed using a vibrating device (bone conductor) placed on the skin over the mastoid. A significant difference between AC and bone conduction (BC) (air–bone gap) suggests a conductive deafness, as occurs in OME (Figure 8.2).
Cranial nerves
Published in Ian Mann, Alastair Noyce, The Finalist’s Guide to Passing the OSCE, 2021
Place a vibrating tuning fork (256 or 512 Hz) on the mastoid process, posterior to the ear. Ask the patient to tell you when they can no longer hear a sound. At that point, angle the fork towards the auricular meatus, the sound should be heard again. This is a normal test result, otherwise known as Rinne positive. Air conduction should be better than bone conduction. If sound is heard better through bone than through the normal conducting system (bone conduction is greater than air conduction), the patient has conductive hearing loss and is Rinne negative. In sensorineural deafness, air conduction often exceeds bone conduction, and so is Rinne positive, but may give false negatives. For this reason, the Rinne test should be used in conjunction with the Weber test.
Management of bilateral locally advanced squamous cell carcinoma of the external auditory canal
Published in Acta Oto-Laryngologica Case Reports, 2022
Naoki Nishio, Yuriko Okazaki, Akihisa Wada, Hidenori Tsuzuki, Miki Kambe, Yasushi Fujimoto, Michihiko Sone
In patients who underwent temporal bone resection for EAC cancer, commonly used air conduction hearing aids were not effective due to ear canal stenosis or closure. Bone conduction is an efficient pathway for sound transmission that can be harnessed to provide hearing amplification. Bone conduction hearing aids or bone-anchored hearing aids (BAHAs) may be indicated when ear canal pathology precludes the use of a conventional air conduction hearing aid [10]. Moreover, cartilage conduction hearing aids have also been developed, and adult patients with ear canal stenosis or closure are the best candidates for cartilage conduction hearing aids, regardless of their hearing thresholds [11]. This patient continued using an air conduction hearing aid in the contralateral ear and then presented with chronic inflammation of the otitis externa. Using alternatives to air-conducted hearing aids, such as bone conduction hearing aids, BAHAs, and cartilage conduction hearing aids, might be helpful in improving the hearing threshold in the surgical ear and in controlling chronic inflammation in the contralateral ear.
Prevalence of extended high-frequency hearing loss among adolescents from two rural areas in Colombia
Published in International Journal of Audiology, 2021
Daniel Peñaranda, Lucía C. Pérez-Herrera, Diana Hernández, Sergio Moreno-López, Ilene Perea, Mario Jacome, Nancy Suetta-Lugo, Juan Manuel García, Augusto Peñaranda
After the otoscopic examination, audiometry was conducted using standardised protocols to measure the intensity (loudness level) in decibels (dB) at which a tone could be heard at a specific frequency (Niskar et al. 2001). Air and bone conduction thresholds were also measured. Adolescents were tested in a double-walled soundproof booth (Amplivox) meeting criteria of maximum permissible ambient noise levels for audiometric test rooms established in the ANSI/ASA S3.1-1999 (R2013) standard guidelines. Audiometry was performed using an R37a (Resonance) model audiometer calibrated to American National Standards Institute (ANSI) 3.6 guidelines, 2018 edition. Air conduction thresholds were obtained using Radioear DD-45 supra-aural headphones for the pure tone audiometry conventional frequencies, and circumaural Sennheiser HD 300 headphones for the EHFA ranges. Bone conduction was tested using a bone conduction transducer. Two professional audiologists with vast experience in audiological testing performed these examinations. The audiometric frequencies included in the test were conventional (0.25- 8 kHz) through pure tone audiometry, extended high frequencies (9- 20 kHz) through the EHFA. The threshold value was established as the lowest intensity signal that adolescents were able to detect at least 50% of the time through a minimum of 3 trials. Tympanometry test was not performed in the study.
Bone-conduction hearing aid is effective in congenital oval window atresia
Published in Acta Oto-Laryngologica, 2021
Mengdie Gao, Chunli Zhao, Jinsong Yang, Peiwei Chen, Yujie Liu, Danni Wang, Shouqin Zhao
In this study, the average ABG in patients with congenital oval window atresia was nearly 60 dBHL, which was similar to a previous epidemiological investigation in China [14]. BC in patients with conductive hearing loss caused by oval window atresia is often considered to be within the normal range. Some studies have also demonstrated bone-conduction hearing loss in such patients, which was consistent with the findings of our study. Studies that have confirmed the loss of BC thresholds in patients with congenital ear malformations have associated the same with the bony atretic of EAC and middle ear conduction system, particularly the inertia of ossicular chain [15]. However, this phenomenon is not universal. Chen K et al. [16] studied cats to explore changes in bone-conduction hearing thresholds after obstructing the round or oval window, and found that the obstruction led to an increase in the air-conduction thresholds at all frequencies and bone-conduction thresholds at 2–8 kHz. These findings indicated that the characteristics of increased bone-conduction hearing thresholds at high frequencies (specifically at 2 kHz) can be used as an important reference to identify HRCTs in cases where it is difficult to determine the etiologies of conductive hearing loss. However, it is necessary to study the same in larger samples to identify the presence or absence of differences in the bone-conduction hearing thresholds between the groups with EAC atresia, EAC stenosis, and simple middle ear malformations [17].