Diagnostic Accuracy of Tuning Fork Tests for Hearing Loss: A Systematic Review

Abstract

Objective (1) To determine the diagnostic accuracy of tuning fork tests (TFTs; Weber and Rinne) for assessment of hearing loss as compared with standard audiometry. (2) To identify the audiometric threshold at which TFTs transition from normal to abnormal, thus indicating the presence of hearing loss. Data Sources PubMed, Ovid Medline, EMBASE, Web of Science, Cochrane, and Scopus and manual bibliographic searches. Review Methods A systematic review of studies reporting TFT accuracy was performed according to a standardized protocol. Two independent evaluators corroborated the extracted data and assessed risk of bias. Results Seventeen studies with 3158 participants, including adults and children, met inclusion criteria. The sensitivity and specificity of the Rinne test for detecting conductive hearing loss ranged from 43% to 91% and 50% to 100%, respectively, for a 256-Hz fork and from 16% to 87% and 55% to 100% for a 512-Hz fork. The audiometric thresholds at which tests transition from normal to abnormal ranged from 13 to 40 dB of conductive hearing loss for the Rinne test and from 2.5 to 4 dB of asymmetry for the Weber test. Significant heterogeneity in TFT methods and audiometric thresholds to define hearing loss precluded meta-analysis. There is high risk of bias in patient selection for a majority of the studies. Conclusion Variability exists in the reported test accuracy measurements of TFTs for clinical screening, surgical candidacy assessments, and estimation of hearing loss severity. Clinicians should remain mindful of these differences and optimize these techniques in specific clinical applications to improve TFT accuracy.

Field-testing of a rapid survey method to assess the prevalence and causes of hearing loss in Gao’an, Jiangxi province, China

“…In future research, we will examine whether the addition of tympanometry may help with assigning the type, and reduce the proportion of unknown causes. Tympanometry may be useful in the diagnosis of OME, which can be more difficult to determine from otoscopy alone [48].…”

Role of Hum Test in Diagnosis of Hearing Loss

“…For the diagnosis of hearing loss, PTA is a simple gold standard diagnos c tool performed in day to day prac ce by the audiologists as per referred by the otorhinolaryngologists. PTA is easy to perform and gives valuable informa on regarding type, configura on of hearing loss and further management 19 planning.…”

“…CHL was labeled for pa ent with airbone gap (ABG) >10 dB and AC threshold >25dB. Pa ents were labelled as SNHL when both AC and BC curve threshold 14,19 > 25dB and ABG < 10dB.…”

Contralateral Occlusion Test (COT): the effect of external ear canal occlusion with aging

“…Bedside testing may be used as a screening procedure for testing hearing in the office or in an emergency (11,12,18) . While formal audiometry is preferable, it may not always be possible for reasons of expense or accessibility.…”

“…We designed a bedside test that permit quantitative evaluation of hearing loss in the presence of unilateral conductive hearing loss. After the confirmation of unilateral conductive hearing loss with Weber and Rinne tests (10)(11)(12)(13)(14)(15) , the COT is carried out with total occlusion of the external auditory meatus (EAM) of the contralateral ear (the unaffected ear). This will produce a hearing loss in the unaffected ear that can be higher, lower, or similar to that in the affected ear.…”