![]() None of the temporal bone morphologic changes were found to be correlated with the degree of either sensorineural or conductive hearing loss. Three patients had significant sensorineural hearing loss, two had conductive hearing loss and one patient had combined hearing loss. All had a history of frequent otitis media and four had experienced tympanic membrane tube insertion. ![]() hearing deficit in achondroplasia, audiometric studies and ENT evaluation were performed in eight of the nine patients. In order to determine whether these morphologic changes are the cause of the. These included narrowing of the skull base and "towering" petrous ridges resulting in abnormal orientation of the inner and middle ear structures. The scratch test proved to be more accurate than traditional postoperative tuning fork assessment and provides a quick, accurate, and simple solution for when such equipment is unavailable.Ĭharacteristic temporal bone changes have recently been defined by high resolution CT in nine patients with achondroplasia (Cobb et al., Am J Neuroradiol 9:1195, 1988). Overall, Weber's test had a sensitivity of 73.2% and specificity of 100% compared with a sensitivity of 89.3% and specificity of 100% for the "Scratch Test." No patients had a dead ear after surgery. In comparison, 50 patients lateralized sound to the operated ear with the scratch test. ![]() Assessment with Weber's test found 41 patients to have sound lateralizing to the operated ear. Sixteen mastoid explorations, 14 tympanoplasties, 18 combined approach tympanoplasties, and 8 other procedures were included, all of which had standard external auditory canal packing and head bandage. This was directly compared with a scratch test, by asking the patient the following while scratching the head bandage in the midline: "Can you hear this? And which side is loudest?"įifty-six patients were assessed in total. A Weber's test was performed using a 512-Hz tuning fork, placed midline on the forehead to assess the direction of sound localization. Patients were assessed postoperatively on Day 0 or Day 1 of surgery using a standardized proforma. ![]() This twin-center prospective study assessed major tympanomastoid surgery patients over a 6-month period. To identify whether the scratch test can be used as an alternative to the Weber's test after tympanomastoid surgery. They can therefore be utilised on the ward round, in patients following tympanomastoid surgery, for example. Smartphone-based vibration applications represent a viable, more accessible alternative to tuning forks when assessing for conductive hearing loss. In 19 out of 20 cases, sound lateralised to the right with the iPhone (chi-square test, p > 0.999). Occluding the right ear, the tuning fork lateralised to the right in 19 out of 20 cases. In 20 out of 20 cases, sound lateralised to the left with the iPhone (chi-square test, p = 0.147). Occluding the left ear, the tuning fork lateralised to the left in 18 out of 20 cases. Both the right and left ears were tested with the iBrateMe vibration application on an iPhone and using a 512 Hz tuning fork. Earplugs were used to simulate conductive hearing loss. To demonstrate that smartphone-based vibration applications provide equivalent accuracy to tuning forks when performing Weber's test.ĭata were collected on lay participants with no underlying hearing loss. 34, 135–139Īll patients undergoing tympanomastoid surgery should be assessed post-operatively for a ‘dead ear’ however, tuning forks are frequently inaccessible. (2005) Which is mightier, the tuning fork or the bone oscillator? J Otolarygol. (1994) The validity of tuning fork tests in diagnosing hearing loss. As a means of diagnosing an acute postoperative dead ear the Scratch test is an accurate alternative to the Weber test. The Weber was 93% specific and 93% sensitive for diagnosing a unilateral conductive hearing loss.Ĭonclusions. The scratch test had a specificity of 100% and sensitivity of 100%. In the context of diagnosing a hearing or non-hearing ear, the Weber test had a specificity of 78% and sensitivity of 100%. Positive or negative Scratch test: clinician applies a gentle scratch using index finger to the bandage over the operated ear. 19 patients undergoing routine tympanomastoid surgery for middle ear disease and 18 patients undergoing translabyrinthine surgery for lateral skull base lesions. Southampton University Hospitals NHS Trust. Prospective cohort study with control group. To compare the use of the Weber tuning fork test and ‘Scratch test’ in postoperative patients following tympanomastoid surgery.
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