Results of Federichi Tuning fork test in different bone-air gap sizes

Background: Tuning fork tests, in particular the Federici test, allow to some extent verifying the correctness of subjective audiometry. During the Federici test patients should compare the volume of the tuning fork placed on the tragus or mastoid process. Federici test is considered positive if the sound seems louder from the tragus than from the mastoid process. Federici test is considered negative if the sound of the tuning fork seems louder from the mastoid process than from the tragus. Literature data indicate that the results of certain tuning fork tests may be different if tuning forks are made of different alloys. Publications describing the characteristics of Federici test at presence different sizes of air-bone gap (ABG) are extremely limited. Aim: improving the effectiveness of the hearing loss diagnosis by clarifying the Federici test value in case of conduction hearing loss. Materials and methods: We analyzed 50 audiograms with a sizes of ABG of 10 dB or more at 125 Hz to clarify when the Federici test can be positive or negative. All tuning fork tests were performed with C128 aluminum tuning forks. The Federici test method: after activation the tuning fork it is placed on the mastoid process, then on the tragus. The forms were marked with the results of the following tuning fork tests: Weber, Federici, Bing; and the distance of the patient's perception of whispered and spoken language, the results of audiometric Weber test, pure tone (in the conventional frequency range) and speech audiometry. Results and discussion: Among the audiograms with ABG, a positive Federici test (group I) was observed in 39 cases (57 %), and a negative test (group II) was observed in 30 cases (43 %). Assessment of hearing loss was performed according to the criteria by Bazarov VH and Rozkladka AI (1989). The results of first group: the first degree of hearing loss was registered in 30 cases (76.9 %), the second degree in 6 cases (15.4 %) and the third degree in 3 cases (7.7 %). The results of the second group were following: the first degree of hearing loss was registered in 24 cases (80 %), the second degree was registered in 2 cases (6.7 %) and the third degree was registered in 3 cases (13.3 %). The article contains tables with data of sizes of ABG at different frequencies in cases of positive and negative Federici tests, as well as the difference between air and bone conduction in speech audiometry (performing the test of 50 % numerals discrimination threshold by Kharshak). There are samples of audiograms for both positive and negative Federici tests with the same ABG size given. Conclusions: We studied the characteristics of the Federici test performed with C128 aluminum tuning forks in patients with different sizes of bone-air gap at a frequency of 125 Hz. When ABG is from 10 to 35 at a frequency of 125 Hz, the Federici test can be both positive and negative, because the result is also affected by size of ABG at frequencies of 250, 500 and 1000 Hz. If Federici test is positive, there is a decrease in a difference between air and bone conduction when performing speech audiometry (performing of the test of 50 % numerals discrimination threshold by Kharshak), and if test is negative there is an increase in the difference. The Federici test is always negative when size of ABG is 40 dB and more at a frequency of 125 Hz. Our results partially different from the literature. In particular, we have shown that a positive Federici test can be with a maximum size of ABG 35 dB at a frequency of 125 Hz and clarified in which cases that can be possible. One of the promising directions of research is the diagnostic value of the Federici test in different middle ear pathology.

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I. Notes of observations on musical beats

Proceedings of the Royal Society of London ◽

10.1098/rspl.1879.0155 ◽

1880 ◽

Vol 30 (200-205) ◽

pp. 520-533

Keyword(s):

Tuning Fork ◽

Musical Pitch ◽

Tuning Forks ◽

History Of ◽

The Difference ◽

Made In

During the last three years I have been greatly occupied with observing and counting musical beats, for the purpose of discovering the cause and amount of error in Appunn’s reed tonometer, and of measuring the number of vibrations made in a second by tuning-forks and organs, as materials for my “ History of Musical Pitch.” The following are brief notes of some of the observations then made :— When two musical notes nearly but not accurately form a consonance, or are in unison, they beat. Under ordinary circumstances the number of beats in a second of a disturbed unison is equal to the difference of the number of double vibrations in a second made by each note. It is not so always, as will be shown later on. If x and y be the “ pitch ” or number of vibrations in a second, made by two musical tones, of which y is the sharper ; then, if my — nx =0, the tones form what I have termed a considence , that is, the n th partial of x falls on the same rank or seat as the m th partial of y . Considences are not always consonances, because other partials of the notes may beat roughly, as when m : n = 8 : 9 or 9 :10 or 15 :16, which are well known dissonances, but give appreciable considences. But if the pitch of either x or y be slightly altered, so that my — nx =± b , the two consident partials become what I have termed dissident , or placed on different ranks or seats, and b beats in a second are heard, being called “ sharp” when positive, that is when my > nx , and “ flat ” when negative, that is when my < nx . This includes the unison for which m = n . Hence all beats heard are beats of simple partial tones , however compound may be the tones which contain them. This agrees thoroughly with my observations. Tuning-forks are comparatively simple but always possess an audible second partial or octave, and sometimes higher partials still, capable of being so reinforced by resonance jars properly tuned to them, that beats can be separately obtained from them and counted. This is a matter of great importance in the construction of a tuning-fork tonometer. When the tone is very compound, as in the case of bass reeds (especially those of Appunn’s tonometer, furnished with a bellows giving, when properly managed, a perfectly steady blast for an indefinite length of time), beats can be obtained and counted from the 20th to the 30th and even the 40th partial, without any reinforcement by a resonance jar.

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Harmadikablak-szindróma – osztályozás, diagnózis, terápia

Orvosi Hetilap ◽

10.1556/650.2020.31842 ◽

2020 ◽

Vol 161 (46) ◽

pp. 1944-1952

Author(s):

Péter Kalinics ◽

Imre Gerlinger ◽

Péter Révész ◽

Péter Bakó ◽

Ildikó Végh ◽

...

Keyword(s):

Hearing Loss ◽

Conductive Hearing Loss ◽

Surgical Techniques ◽

Bony Defect ◽

Hearing Tests ◽

The Third ◽

Tuning Forks ◽

Speech Field ◽

Conductive Hearing ◽

Pure Tone Threshold

Összefoglaló. Halláspanasszal számos beteg fordul orvoshoz. A rutinszerűen elvégzett súgottbeszéd-, hangvilla- és tisztahangküszöb-audiometriai vizsgálat alapján vezetéses, sensorineuralis, illetve a kettő együttes fennállása esetén kevert típusú halláscsökkenést különböztetünk meg. Vezetéses halláscsökkenés létrejöhet mind a külső, mind a közép- vagy a belső fül veleszületett vagy szerzett rendellenességei esetén. Amennyiben a stapediusreflex kiváltható, ugyanakkor a betegnél nincs jelen a külső fület, valamint a középfület érintő kórfolyamat, felmerül a harmadikablak-szindróma lehetősége. A kórkép okaként egy, a belső fül csontos tokján „harmadik ablakként” funkcionáló laesio van jelen, amely az ovális ablakon keresztül beérkező hangenergia egy részét elvezeti, mielőtt az a kerek ablakon át kivezetődik a középfülbe. A diagnózis felállítása gyakran nehéz feladat elé állítja a klinikust, melyhez a megfelelő audiológiai, illetve képalkotó vizsgálatok elvégzése elengedhetetlen. Tekintettel arra, hogy a panaszok megszüntetésére számos műtéti módszer került leírásra, közleményünkben átfogó képet adunk a kórkép etiológiájáról, diagnosztikájáról, terápiájáról, valamint bemutatjuk saját kezdeti tapasztalatainkat is 2 eset prezentálásával. Orv Hetil. 2020; 161(46): 1944–1952. Summary. Patients frequently present to the physician with hearing loss. Routine hearing tests include speech field (whisper test), tuning forks and pure tone threshold audiometry, which can identify the presence of sensorineural hearing loss, conductive hearing loss or a combination of both (mixed type). Conductive hearing loss can be a symptom of many different conditions. These include congenital or acquired malformations of the outer, middle and inner ear. If a conductive hearing loss with intact stapedial reflexes are recorded and in the absence of outer or middle ear pathology, then the third window syndrome should be considered. The cause is a bony defect on the otic capsule that acts as a ’third window’, dissipating the incoming sound energy. Without the appropriate audiological and imaging tests, the diagnosis of the condition is challenging in clinical setting. Several surgical techniques have been described to treat the condition. The authors give a comprehensive review of the etiology, diagnosis and treatment of the disease presenting their initial experiences with 2 cases. Orv Hetil. 2020; 161(46): 1944–1952.

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Psychophysical and Physical Techniques for Measuring the Attenuation of Hearing Protectors in the Field

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/154193129303701414 ◽

1993 ◽

Vol 37 (14) ◽

pp. 999-1003

Author(s):

Daniel W. Mauney

Keyword(s):

Hearing Loss ◽

Noise Reduction ◽

Insertion Loss ◽

Noise Exposure ◽

Bone Conduction ◽

Hearing Protectors ◽

Alternative Measures ◽

Hearing Protector ◽

The Difference ◽

Occlusion Effect

A field-implementable measure is needed to estimate the attenuation workers achieve with their hearing protectors in the field. Manufacturer-supplied values overestimate in-field attenuation and reliance on these values could result in greater noise exposure, thus contributing to hearing loss. Alternative measures for assessing a hearing protector's effectiveness were evaluated through comparison to the standardized real-ear attenuation at threshold (1/3-REAT) method (ANSI S3.19-1974). These measures, termed microphone in real ear (MIRE), used miniature microphones underneath and outside of the hearing protector to physically measure the attenuation of the protector using both insertion loss (IL-MIRE) and noise reduction (NR-MIRE) techniques. Results indicate that the MIRE measures differ significantly from the 1/3-REAT method (a psychophysical technique) for attenuation collapsed across protectors, with absolute differences as great as 6.6 dB and the direction of the difference changing due to frequency. At 125 Hz, the MIRE metrics yielded lower attenuation, while from 500 to 8000 Hz, the 1/3-REAT method generally yielded lower attenuation. These differences may be due in part to the occlusion effect and the bone conduction of sound. The size and consistency of these differences across HPDs suggest that these measures hold promise for providing quick and relatively accurate estimations of an HPD's attenuation in the field.

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Hearing Loss Among Excessive Mobile Phone Users; A Cross Sectional Study At Bahawal Victoria And Civil Teaching Hospitals Bahawalpur

Journal of Bahria University Medical and Dental College ◽

10.51985/jbumdc2018074 ◽

2018 ◽

Vol 09 (01) ◽

pp. 21-24

Author(s):

Muhammad Asim Shafique ◽

Muhammad Fahim ◽

Masood Akhtar ◽

Muhammad Adnan Anwar ◽

Anum Jamshed

Keyword(s):

Hearing Loss ◽

Mobile Phone ◽

Pure Tone ◽

Bone Conduction ◽

Pure Tone Audiometry ◽

Test Group ◽

Teaching Hospitals ◽

Control Group ◽

P Value ◽

Cross Sectional

Objective: To assess the hearing loss among the subjects using excessive mobile phone. Methodology: 50 subjects were entered for this study with age ranging from 20 to 40 years using mobile phone for more than 5 years. 25 subjects who used mobile phone for less than (<) 60 min /day formed one group, while 25 subjects who used cell phone for more than (>) 60 min /day formed the second group. The hearing levels of all the subjects were tested using Pure Tone Audiometry (PTA). Duration of mobile phone usage was assessed by questionnaires. Results: There was a significant increase (p-value .00006) in the hearing thresholds at all frequencies in air conduction and bone conduction in right ear in test group compared with the control group. Similar result was found in the left ear except for bone conduction at frequency 4 and 6 (kilo hertz) kHz. Excessive use of mobile phone caused Sensory neural hearing loss and the prevalence was 84% in group who used mobile phone for > 60 min / day and 20% in group who used for < 60 min / day. Conclusion: Excessive use of mobile phone may cause increase in pure tone threshold associated with the duration of usage. The use for more than 5 years with more than 60 minutes daily can produce harmful effects on human hearing.

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Anxiety and Depression in Patients with Sudden One-sided Hearing Loss

Ear Nose & Throat Journal ◽

10.1177/0145561318097010-1101 ◽

2018 ◽

Vol 97 (10-11) ◽

pp. E7-E9 ◽

Cited By ~ 5

Author(s):

Fatih Arslan ◽

Emre Aydemir ◽

Yavuz Selim Kaya ◽

Hasan Arslan ◽

Abdullah Durmaz

Keyword(s):

Hearing Loss ◽

Patient Group ◽

Bone Conduction ◽

Sudden Hearing Loss ◽

Anxiety And Depression ◽

Control Group ◽

Beck Hopelessness Scale ◽

The Difference ◽

Anxiety Depression ◽

Air Conduction

Sudden sensorineural hearing loss is a hearing loss of >30 dB in at least three consecutive frequencies that occurs in 3 days. The aim of this study was to investigate anxiety and depression caused by sudden, idiopathic, one-sided hearing loss. The levels of anxiety and depression in patients with this type of hearing loss were determined using the Beck Anxiety Scale (BAS) and the Beck Depression Inventory (BDI) at the time of the patient's first visit. In total, 56 patients (32 men and 24 women) with a mean age of 32.8 ± 9.9 years (range: 20 to 58 years) were selected as the patient group and 45 individuals without symptoms of anxiety and depression were selected as the control group. The mean pretreatment air-conduction threshold and bone-conduction threshold were 61.1 ± 26.1 and 49.4 ± 13.8, respectively. In the patient group, the pretreatment mean anxiety, depression, and hopelessness scores were 19.5 ± 10.7, 11.6 ± 8.4, and 6.2 ± 4.7, respectively. The control group's mean anxiety, depression, and hopelessness scores were 4.1 ± 3.0, 3.8 ± 2.1, and 1.8 ± 1.0, respectively. For all the tests, the difference between the patient group and the control group was statistically significant (p < 0.001 for all). Hearing levels were not correlated with scores on the BAS, BDI, and Beck Hopelessness Scale (p = 0.1, p = 0.6, and p = 0.4, respectively). In conclusion, the results of this study show that sudden hearing loss can cause anxiety and depression. Questioning patients with sudden hearing loss about symptoms associated with anxiety and depression might be useful, and a psychiatric consultation should be requested if necessary.

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Can smartphone vibration provide a valid alternative to tuning forks for use on the ENT ward round?

The Journal of Laryngology & Otology ◽

10.1017/s0022215119000525 ◽

2019 ◽

Vol 133 (03) ◽

pp. 245-247 ◽

Cited By ~ 1

Author(s):

M E Hopkins ◽

D Owens

Keyword(s):

Hearing Loss ◽

Tuning Fork ◽

Conductive Hearing Loss ◽

Ward Round ◽

Chi Square ◽

Tuning Forks ◽

Chi Square Test ◽

The Right ◽

Conductive Hearing

AbstractBackgroundAll patients undergoing tympanomastoid surgery should be assessed post-operatively for a ‘dead ear’; however, tuning forks are frequently inaccessible.ObjectiveTo demonstrate that smartphone-based vibration applications provide equivalent accuracy to tuning forks when performing Weber's test.MethodsData were collected on lay participants with no underlying hearing loss. Earplugs were used to simulate conductive hearing loss. Both the right and left ears were tested with the iBrateMe vibration application on an iPhone and using a 512 Hz tuning fork.ResultsOccluding the left ear, the tuning fork lateralised to the left in 18 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 right ear, the tuning fork lateralised to the right in 19 out of 20 cases. In 19 out of 20 cases, sound lateralised to the right with the iPhone (chi-square test, p > 0.999).ConclusionSmartphone-based vibration applications represent a viable, more accessible alternative to tuning forks when assessing for conductive hearing loss. They can therefore be utilised on the ward round, in patients following tympanomastoid surgery, for example.

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Clinical applications of transcranial bone conduction attenuation in children

The Journal of Laryngology & Otology ◽

10.1017/s0022215100128269 ◽

1994 ◽

Vol 108 (10) ◽

pp. 834-836 ◽

Cited By ~ 7

Author(s):

Iyngaran Vanniasegaram ◽

Jane Bradley ◽

Sue Bellman

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Bone Conduction ◽

Clinical Applications ◽

Sensorineural Hearing ◽

Common Belief ◽

Sound Perception ◽

Significant Attenuation ◽

The Difference

AbstractIt is a common belief that there is no significant transcranial attenuation across the skull by bone conduction (BC). In 32 children with proven unilateral sensorineural hearing loss the unmasked bone thresholds were measured on each side. There was a significant attenuation of BC at 4 kHz. Transcranial attenuation of BC at 4 kHz may explain the difference in sound perception between the two ears when bone conduction amplification is used. Further research should be undertaken to identify the better cochlea in mixed hearing losses.

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A CLINICO-PATHOLOGICAL & AUDIOLOGICAL STUDY OF SENSORINEURAL HEARING LOSS IN PATIENTS WITH CHRONIC OTITIS MEDIA :-IS THERE A SIGNIFICANT CORRELATION ?

10.36106/ijar/9306140 ◽

2020 ◽

pp. 80-82

Author(s):

Mukherjee Ankita Atin ◽

Vasudha Kesarwani ◽

Shivaam Kesarwaani

Keyword(s):

Hearing Loss ◽

Sensorineural Hearing Loss ◽

Otitis Media ◽

Pearson Correlation ◽

Bone Conduction ◽

Chronic Otitis Media ◽

Sensorineural Hearing ◽

Cross Sectional ◽

Duration Of Disease ◽

The Difference

Introduction: Chronic otitis media (COM) is one of the most common disorder in eld of ENT. Hearing loss as a sequel of chronic otitis media (COM) is often conductive, but there has been a controversy in different studies with association of sensorineural hearing loss and COM . The aim of the study was to determine the association between COM and sensorineural hearing loss (SNHL) and to assess the inuence of patient's age, duration of disease, type of COM and presence of cholesteatoma on the presence of SNHL. Material & Methods: This was a cross sectional descriptive study of 100 subjects between the age group of 5 and 50 years. Patients having unilateral chronic otitis media of both mucosal and squamosal types, who met the inclusion criteria of unilateral otorrhea, normal contralateral ear on otoscopy, with no history of head trauma or ear surgery or familial hearing loss were selected. All patients were evaluated clinically and audiologically. The age, type, duration of disease and presence of cholestetoma is correlated with degree of sensorineural hearing loss. Interaural differences in bone conduction thresholds at 500 Hz, 1 kHz, 2 kHz and 4 kHz were also noted. Data analysis was performed using SPSS 13 with independent-samples t-test, Pearson correlation test, and twotailed analysis. A p ≤ 0.05 was considered statistically signicant. Results: Signicant higher BC thresholds were found in the affected ear than in the normal ear for each frequency (p < 0.001), which increased with increasing frequency (4.9 dB at the 500 Hz and 9.85 dB at the 4000 Hz). A strongly signicant correlation was observed between patients' age and the degree of SNHL (r = 0.401, p < 0.001) but no signicant correlation was in duration of the disease (r = 0.108, p > 0.05). There was no relationship between presence of cholesteatoma with SNHL across all frequencies (p < 0.05). Conclusion: A signicant association between SNHL and COM was found in this study. The difference in BC thresholds increased with increasing frequency. Patients' age was signicantly correlated with the degree of SNHL, but no signicant association was observed between SNHL with duration of disease. Presence of cholesteatoma and development of SNHL were found to be correlated in this study.

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Utility of Rinne’s tuning fork test for quantitative assessment of conductive hearing loss

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20203988 ◽

2020 ◽

Vol 6 (10) ◽

pp. 1878

Author(s):

Shivakumar Senniappan ◽

Rohith Chendigi

Keyword(s):

Hearing Loss ◽

Retrospective Study ◽

Sample Size ◽

Quantitative Assessment ◽

Tuning Fork ◽

Conductive Hearing Loss ◽

Medical College ◽

Hearing Acuity ◽

Tuning Forks ◽

Conductive Hearing

Background: The Rinne tuning fork test is used routinely in clinical ENT examination. It is used to assess the person’s hearing acuity. Ideally, 3 tuning forks are used 256, 512 and 1024 Hz. Rinne tuning fork tests can be used to diagnose conductive hearing loss. Aim of our study an attempt is made to find the utility of three different tuning forks (256,512,1024 Hz) for quantification of conductive hearing loss and their accuracy.Methods: A retrospective study with a sample size of 300 was undertaken over 12 months from April 2018 to March 2019 at the out-patient department of ENT of VMKV medical college and hospital, Salem. Patients of both sexes and aged above 10 yrs presenting with conductive hearing loss due to varied etiology were subjected to complete ENT examination including Rinne test with three different tuning forks (256, 512, 1024 Hz).Results: The results of all the tuning forks (256, 512, 1024 Hz) shows that 29 patients were Rinne’s positive to all tuning forks had the air-bone gap range of 15 dB to 19 dB with a mean air-bone gap of 17.63 dB. 83 patients were negative to 256 Hz tuning fork but positive to 512 and 1024 Hz tuning forks had the air-bone gap range of 20 to 29 dB with a mean air-bone gap of 25.46 dB.Conclusions: We conclude that Rinne’s tuning fork test can be used to quantify the degree of conductive hearing loss into mild (20-30 dB), moderate (30-45 dB), and severe (45-60 dB).

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Do eyeglasses and palatal prostheses affect the results of the Weber test?

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20190755 ◽

2019 ◽

Vol 5 (2) ◽

pp. 254

Author(s):

Yavuz Atar ◽

Ziya Salturk ◽

Guler Berkiten ◽

Tolgar Lutfi Kumral ◽

Yavuz Uyar ◽

...

Keyword(s):

Hearing Loss ◽

Tuning Fork ◽

Tuning Forks ◽

Group 2 ◽

Group 1

Background: The aim of the study was to analyze the possible effects of eyeglasses and palatal prostheses on the results of the Weber tuning fork test.Methods: We enrolled 96 patients diagnosed with unilateral conductive-type hearing loss. All were aged between 18 and 65 years. Group 1 was composed of 48 patients with eyeglasses and group 2 included 48 patients with palatal prostheses. All patients underwent the weber tuning fork test with and without their eyeglasses and prostheses, and the results were compared. Weber tests were performed using 256 Hz and 512 Hz tuning forks. Results: No significant between-group difference was apparent (both p>0.05).Conclusions Neither eyeglasses nor palatal prostheses significantly affected the results of the Weber test.

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