ENT Diagnostic Procedures 2

Question 1

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

Accepted Answer

Tympanic membrane perforation or patent PE tube

Answer

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.

Question 2

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

Accepted Answer

Left conductive hearing loss

Answer

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

Question 3

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

Accepted Answer

Interaural wave V latency difference greater than 0.2 ms

Answer

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

Question 4

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

Accepted Answer

Auditory neuropathy spectrum disorder

Answer

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

Question 5

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

Accepted Answer

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

Answer

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

ENT - Ear, Nose, and Throat Specialist Certification Practice Test