Background: Extended high-frequency (EHF) audiometry (8?16 kHz) has an important role in audiological assessments such as ototoxicity monitoring, and for speech recognition and localization. Accurate and reliable EHF testing with smartphone technologies has the potential to provide more affordable and accessible hearing-care services, especially in underserved contexts. Purpose: To determine the accuracy and test?retest reliability of EHF audiometry with a smartphone application, using calibrated headphones. Research Design: Air-conduction thresholds (8?16 kHz) and test?retest reproducibility, recorded with conventional audiometry (CA) and smartphone audiometry (SA), using audiometric (Sennheiser HDA 300 circumaural) and nonstandard audiometric (Sennheiser HD202 II supra-aural) headphones, were compared in a repeated-measures design. Study Sample: A total of 61 participants (122 ears) were included in the study. Of these, 24 were adults attending a tuberculosis clinic (mean age = 36.8, standard deviation [SD] = 14.2 yr; 48% female) and 37 were adolescents and young adults recruited from a prospective students program (mean age = 17.6, SD = 3.2 yr; 76% female). Of these, 22.3% (n = 326) of EHF thresholds were ?25 dB HL. Data Analysis: Threshold comparisons were made between CA and SA, with audiometric headphones and nonstandard audiometric headphones. A paired samples t-test was used for comparison of threshold correspondence between conventional and smartphone thresholds, and test?retest reproducibility of smartphone thresholds. Results: Conventional thresholds corresponded with smartphone thresholds at the lowest intensity (10 dB HL), using audiometric and nonstandard audiometric headphones in 59.4% and 57.6% of cases, respectively. Conventional thresholds (exceeding 10 dB HL) corresponded within 10 dB or less, with smartphone thresholds in 82.9% of cases using audiometric headphones and 84.1% of cases using nonstandard audiometric headphones. There was no significant difference between CA and SA, using audiometric headphones across all frequencies (p > 0.05). Test?retest comparison also showed no significant differences between conditions (p > 0.05). Smartphone test?retest thresholds corresponded within 10 dB or less in 86.7% and 93.4% of cases using audiometric and nonstandard audiometric headphones, respectively. Conclusions: EHF smartphone testing with calibrated headphones can provide an accurate and reliable option for affordable mobile audiometry. The validity of EHF smartphone testing outside a sound booth as a cost-effective and readily available option to detect high-frequency hearing loss in community-based settings should be established.

A 21-year-old woman was referred with a 1-year history of nocturnal enuresis, frequency, poor urinary flow, suprapubic discomfort and occasional inability to pass urine. On examination her external urethral meatus was possibly narrowed. Cystoscopy was normal and urethral dilatation was performed, which improved the symptoms briefly.Two years later she was seen again because of persisting symptoms. Her pelvic tone and perineal sensation were normal. Urodynamics were performed; her filling cystometry was abnormal with a first sensation to void at only 13 mL of urine. Detrusor pressures were normal until a capacity of 120 mL, when she started to have marked unstable contractions, with pressures reaching nearly 60 cmH 2 O. Her cystometric capacity was 123 mL. During a static phase after reaching cystometric capacity, she had marked episodes of unstable spontaneous bladder contractions; voiding uroflowmetry was normal.Two years later she was referred to our department with a 6-month history of episodic sensory and visual disturbance; MRI of the brain confirmed the diagnosis of multiple sclerosis. CommentIn retrospect, it was clear that the patient's bladder symptoms were the first manifestation of multiple scler- Case reportA healthy 36-year-old man was admitted to the emergency room after falling from a horse. A history and a complete left ureteric duplication with an ectopic megaureter opening into the prostate which was associated with a hydronephrotic superior pole of the left kidney and a major cortical atrophy. Superior hemiureteronephrectomy was performed and upon exposing the superior pole of the kidney, a yellow nodular mass 1 cm in diameter was seen (Fig. 1). The pathological examination showed a well-differentiated RCC with defined limits and no invasion of the surrounding fat or blood vessels. Because the tumour was small, no further treatment was undertaken. Although the tumour was not detected pre-operatively by the radiologists, a retrospective examination of the CT scan disclosed a corresponding nodular lesion (Fig. 2). After an uneventful post-operative course, the patient was well after 6 months and was advised to undergo an annual CT scan. CommentThe first peculiarity of this case was the detection of a duplicated ureter complicated by an advanced uretero- Case reportA 19-year-old woman was referred to us when ultrasonography arranged by her family physician for evaluating recurrent symptomatic lower urinary tract infections showed a mass within the wall of the bladder. She was otherwise well, with no other medical history, had no family history of inherited disorders and examination revealed no abnormal findings. Specifically, there were no areas of skin pigmentation nor subcutaneous nodules. The ultrasonogram showed normal upper tracts, but a 7×10 mm mass was noted in the pelvis within the muscular wall of the bladder (Fig. 1). At cystoscopy, the mass could be seen medial to the left ureteric orifice and was firm in texture with a mobile, normal overlying mucosa. Complete resection of the les...