Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-23T23:48:43.490Z Has data issue: false hasContentIssue false

Misdiagnosis of hearing loss due to ear canal collapse: a report of two cases

Published online by Cambridge University Press:  29 June 2007

Cliodna F. O Mahoney*
Affiliation:
Department of Audiological Medicine, Royal National Throat, Nose and Ear Hospital, London, UK.
Linda M. Luxon
Affiliation:
Department of Audiological Medicine, Royal National Throat, Nose and Ear Hospital, London, UK.
*
Address for correspondence: Dr Cliodna F. O Mahoney, Dept of Audiological Medicine, Royal National Throat, Nose and Ear Hospital, 330 Gray's Inn Road, London WC1X 8DA.

Abstract

Collapse of the external auditory meatus during audiometry can lead to spuriously increased hearing thresholds being obtained, particularly at high frequencies, and may simulate conditions such as noise-induced hearing loss, presbyacusis and retrocochlear pathology. Consequently, inappropriate investigations and management may be undertaken. Two patients with elevated thresholds secondary to ear canal collapse are described. The implications of initially failing to identify the true nature of their ‘hearing losses’ are highlighted and strategies to avoid such pitfalls are discussed.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anderson, H., Barr, B. (1971) Conductive high-tone hearing loss. Archives of Otolaryngology 93: 599605.CrossRefGoogle ScholarPubMed
Bess, J. C. (1971) Ear canal collapse. A review. Archives of Otolaryngology 93: 408412.CrossRefGoogle ScholarPubMed
British Standards Institution (1988) I.S.O. 389 – Part 5. Standard reference zero for the calibration of pure tone air conduction audiometers. Specification for a standard reference zero using an acoustic coupler complying with BS 4668.Google Scholar
Bryde, R. L., Feldman, A. S. (1980) An approach to the management of the collapsing ear canal. ASHA 22: 734.Google Scholar
Burkhard, M. D., Corliss, E. L. R. (1954) The response of earphones in ears and couplers. Journal of the Acoustical Society of America 26(5): 679685.CrossRefGoogle Scholar
Chaiklin, J. B., McClellan, M. E. (1971) Audiometric management of collapsible ear canals. Archives of Otolaryngology 93: 397–107.CrossRefGoogle ScholarPubMed
Chandler, J. R. (1964) Partial occlusion of the external auditory meatus: Its effect upon air and bone conduction acuity. Laryngoscope 74: 2254.CrossRefGoogle Scholar
Coles, R. A. (1967) External meatus closure by audiometer earphone. Journal of Speech and Hearing Disorders 32: 296297.CrossRefGoogle Scholar
Creston, J. E. (1965) Collapse of the ear canal during routine audiometry. Journal of Laryngology 79: 893901.CrossRefGoogle ScholarPubMed
Creston, J. E., Tice, R. E. (1964) Collapse of the ear canal during audiometry. Archives of Otolaryngology 79: 389392.CrossRefGoogle ScholarPubMed
Dick, J. C. (1947) Observations on the elastic tissue of the skin with a note on the reticular layer at the junction of the dermis and epidermis. Journal of Anatomy 81: 201211.Google ScholarPubMed
Erber, N. P. (1968) Variables that influence sound pressures generated in the ear canal by an audiometric earphone. Journal of the Acoustical Society of America 44(2): 555562.CrossRefGoogle ScholarPubMed
Hildyard, V. H., Valentine, M. A. (1962) Collapse of the ear canal during audiometry. Archives of Otolaryngology 75: 422423.CrossRefGoogle ScholarPubMed
Killion, M. C., Villchur, E. (1989) Comments on 'Earphones in audiometry' (Zwislocki et al., Journal of the Acoustical Society of America 83: 1688–1689 (1988)). Journal of the Acoustical Society of America 85(4): 17751779.CrossRefGoogle Scholar
Klockhoff, I. (1961) Middle ear muscle reflexes in man. Acta Otolaryngologica (suppl 164): 192.Google ScholarPubMed
Ma, C. K., Cowdry, E. V. (1950) Aging of elastic tissue in human skin. Journal of Gerontology 5: 203210.CrossRefGoogle ScholarPubMed
Marshall, L., Grossman, M. A. (1982) Management of earcanal collapse. Archives of Otolaryngology 108: 357361.CrossRefGoogle ScholarPubMed
Marshall, L., Martinez, S. A., Schlaman, M. E. (1983) Reassessment of high-frequency air-bone gaps in older adults. Archives of Otolaryngology 109: 601606.CrossRefGoogle ScholarPubMed
Mustain, W. D., Hasseltine, H. E. (1981) High frequency conductive hearing loss. A case presentation. Laryngoscope 91: 599604.CrossRefGoogle ScholarPubMed
Pearlman, R. C. (1975) Preventing collapse of external auditory meatus during audiometry. Archives of Otolaryngology 101: 686688.CrossRefGoogle ScholarPubMed
Penrod, J. P. (1981) Ear canal collapse: A case presentation. Ear and Hearing 2: 8889.CrossRefGoogle ScholarPubMed
Randolph, L. J., Schow, R. L. (1983) Threshold inaccuracies in an elderly clinical population: Ear canal collapse as a possible cause. Journal of Speech and Hearing Research 26: 5458.CrossRefGoogle Scholar
Shipton, M. S. (1979) Tables relating pure-tone audiometric threshold to age. National Physical Laboratory Acoustics Report 94.Google Scholar
Ventry, I. M., Chaiklin, J. B., Boyle, W. F. (1961) Collapse of the ear canal during audiometry. Archives of Otolaryngology 73: 727731.CrossRefGoogle ScholarPubMed
Villchur, E. (1970) Audiometer-earphone mounting to improve intersubject and cushion-fit reliability. Journal of the Acoustical Society of America 48: 13871396.CrossRefGoogle ScholarPubMed
Zwislocki, J., Kruger, B., Miller, J. D., Niemoeller, A. F., Shaw, E. A., Studebaker, G. (1988) Earphones in audiometry. Journal of Acoustical Society of America 83: 16881689.CrossRefGoogle ScholarPubMed