Diagnostic Procedures Flashcards

A flat (Type B) tympanogram with an abnormally large ear canal volume most likely indicates which finding?

Answer: Tympanic membrane perforation or patent PE tube

A large physical volume with a flat trace means the probe is measuring the canal plus middle ear space, as seen with a perforation or open tube.

Weber lateralizes to the left ear and Rinne is negative (BC > AC) on the left. What is the most likely diagnosis?

Answer: Left conductive hearing loss

Weber lateralizing to the side with a negative Rinne indicates a conductive loss in that ear.

Which ABR finding is most suggestive of a retrocochlear lesion such as a vestibular schwannoma?

Answer: Interaural wave V latency difference greater than 0.2 ms

A prolonged wave V or an interaural wave V difference above about 0.2 ms raises suspicion for retrocochlear pathology.

A child has present otoacoustic emissions but an absent or severely abnormal ABR. What does this pattern suggest?

Answer: Auditory neuropathy spectrum disorder

Intact outer hair cell function (OAEs) with abnormal neural synchrony (ABR) defines auditory neuropathy spectrum disorder.

On electrocochleography, which finding supports a diagnosis of Meniere disease?

Answer: Elevated summating potential to action potential (SP/AP) ratio

Endolymphatic hydrops typically produces an elevated SP/AP ratio on ECochG.

Word recognition scores that worsen significantly as presentation level increases (rollover) suggest which type of lesion?

Answer: Retrocochlear

Significant rollover on the performance-intensity function is a classic retrocochlear sign.

Which acoustic reflex finding is most consistent with a retrocochlear lesion on the stimulated side?

Answer: Positive acoustic reflex decay

Reflex decay of more than 50% within 10 seconds indicates abnormal neural adaptation typical of retrocochlear disease.