The effect of degree of hearing loss on diagnostic test strategy: report of a case.
We discuss test results in a single case of eighth nerve disorder. The patient was evaluated twice, once when sensitivity loss was only mild and once when sensitivity loss was severe. Diagnostic contribution of individual test measures depended on degree of sensitivity loss. When the loss was only mild, the acoustic reflex test and auditory brain-stem response (ABR) audiometry were most sensitive to eighth nerve disorder. When sensitivity loss was severe, results of the acoustic reflex test and ABR audiometry became ambiguous. At that time, the more "traditional" audiometric test battery of Bekesy audiometry, suprathreshold adaptation test (STAT), and speech audiometry provided the most useful diagnostic information. Since degree of sensitivity loss at the time of initial evaluation is an uncontrollable variable, diagnostic strategy must include tests appropriate to a wide range of hearing loss.
D000158:Acoustic Impedance Tests; D000328:Adult; D001299:Audiometry; D001300:Audiometry, Evoked Response; D001301:Audiometry, Pure-Tone; D001302:Audiometry, Speech; D006313:Hearing Loss, Central / Q000175:diagnosis*; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis*; D006801:Humans; D008297:Male