Tuning fork in medical use1/1/2024 However, among patients presenting with sudden unilateral hearing loss, lateralization of the Weber test to the contralateral ear very reliably predicts a sensorineural etiology, and such patients should be promptly referred and treated accordingly. In light of these data, clinicians should be alert to the possibility of sudden SNHL being overlooked in patients without the expected tuning fork findings. Thus, if a Weber test unexpectedly lateralizes to the asymptomatic, better hearing ear, this finding should prompt immediate audiometric testing, and urgent otologic referral if a sensorineural loss is confirmed. Most patients with alternative diagnoses routinely considered by primary care providers, such as cerumen impaction, Eustachian tube dysfunction, or otitis media, will present with a conductive hearing loss. The high reliability of the Weber test when it lateralized away from the suspect ear confirms that the test retains value in the clinical setting when assessing a patient presenting with acute hearing complaints. The finding that the Weber test did not lateralize or could not be heard in over 20% of study participants was consistent with other reports that conclude that Weber test results can be unreliable. 6 This study was undertaken to evaluate whether the Weber test might help identify patients with suspected SNHL who require prompt referral and treatment. Since most patients who experience a sudden SNHL are seen in a primary care setting, and since more common conditions are often difficult to distinguish based on clinical assessment alone, referral for specialty evaluation and audiometry are frequently delayed beyond the ideal therapeutic window. We hypothesized that the Weber test would be a useful clinical metric to diagnose unilateral SNHL. 4 Tuning fork testing and formal audiometry were performed as part of the baseline assessment of eligible study participants, creating a robust database that facilitates a prospective evaluation of the utility of the Weber test in this setting. Because hearing is a function of both mechanical components of the ossicles and neural components of the cochlea, hearing loss can be either conductive. 2, 3Ī recent multicenter, randomized controlled clinical trial compared oral and intratympanic corticosteroids for sudden SNHL. Tuning forks are an effective tool clinicians can employ to test a patient’s hearing, but this goes beyond the simple task of being able to hear a tone. However, the role of tuning fork testing in the initial workup of hearing complaints has not been clearly elucidated. As such, tuning forks have the potential to assist with initial treatment and appropriate triage because they are available, inexpensive, and easy to use. 1 Because patients frequently seek initial evaluation in urgent care or primary care settings, audiologic assessment may not be immediately available. Sudden sensorineural hearing loss (SNHL) is a condition for which prompt diagnosis and initiation of treatment is of paramount importance. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.
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