The values of the Rinne and Weber tests were not good in the diagnosis of mild conductive hearing loss when the air-bone gap was 5-35 dB. It lateralized to the poorer ear in 63% of ears with unilateral conductive hearing loss. The Weber test was in midline in 96-98% of ears with bilateral normal hearing or sensorineural hearing loss. The lateralization in the Weber test occurred at a difference of 2.5 dB between the right and left ear. In midline Weber results, the mean value of the air conduction difference at 0.25 kHz between the right and left ear was 1.4 dB. The Rinne test changed from positive to negative at 13 dB when performed using the normal loudness comparison method. The Rinne test was positive in 97% of ears with normal hearing or sensorineural hearing loss and negative in 72% of ears with conductive hearing loss. The Rinne and the Weber tests were carried out using a 256-Hz tuning fork on 687 6- to 15-year-old school children, the majority of whom were normally hearing subjects. The Weber and Rinne tests should not be used for general screening. Individuals who perceive the whispered voice require no further testing, while those unable to perceive the voice require audiometry. Not passing the audioscope test has an LR of 2.4 (95% CI, 1.4-4.1) passing has an LR of 0.07 (95% CI, 0.03-0.17).Įlderly individuals who acknowledge they have hearing impairment require audiometry, while those who reply no should be screened with the whispered-voice test. Inability to perceive a whispered voice has an LR of 6.1 (95% CI, 4.5-8.4) normal perception has an LR of 0.03 (95% CI, 0-0.24). An abnormal Rinne tuning fork test response has LRs ranging from 2.7 to 62 a normal response has LRs from 0.01 to 0.85. An abnormal Weber tuning fork test response has an LR of 1.6 (95% CI, 1.0-2.3) a normal response has an LR of 0.70 (95% CI, 0.48-1.0). A score of 8 or greater on the screening version of the Hearing Handicap Inventory for the Elderly (HHIE-S) has an LR of 3.8 (95% CI, 3.0-4.8) a score less than 8 has an LR of 0.38 (95% CI, 0.29-0.51). Each included study (n = 24) was assigned a methodological grade.Ī yes response when asking individuals whether they have hearing impairment has a summary likelihood ratio (LR) of 2.5 (95% confidence interval, 1.7-3.6) a no response has an LR of 0.13 (95% CI, 0.09-0.19). One author screened all potential articles and 2 authors independently abstracted data. Medical Subject Headings or keywords used in the search included hearing loss, hearing handicap, hearing tests, tuning fork, deafness, physical examination, sensitivity, specificity, audiometry, tuning fork tests, Rinne, Weber, audioscope, Hearing Handicap Inventory for the Elderly-Screening version, whispered voice test, sensorineural, and conductive. Articles that used unaccepted reference standards or contained insufficient data were excluded. Original studies on the accuracy or precision of screening questions and tests were included. MEDLINE and EMBASE databases (1966 to April 2005) were searched for English-language articles related to screening for hearing impairment. To review the accuracy and precision of bedside clinical maneuvers for diagnosing hearing impairment.

Hearing impairment is prevalent among the elderly population but commonly underdiagnosed. The implementation of routine School Ear and Hearing Programs could be beneficial, and should reduce the national burden of ear diseases. While age was a significant factor for OME, it was not a significant factor for OME-associated hearing loss.Įar diseases with associated hearing loss are a significant public health problem among primary school students in the Solomon Islands. Among students with OME in at least one ear, 50% failed audiometry screening in the affected ear. The follow-up attendance rate at the ENT Clinic was 81.1%. The most common ear pathology was Otitis Media with Effusion (OME) (34.2%), followed by impacted wax (22.8%), and Chronic Suppurative Otitis Media (3.1%). Students were referred to the ENT Clinic for medical intervention and/or pure-tone audiometry assessment.Ī total of 342 students (56.6%) did not pass their ear examination, with a significantly higher fail rate among younger students (p < 0.001). School-based ear examinations were performed, including otoscopy and tuning-fork tests. The present study aimed to assess the prevalence of otitis media and associated hearing loss among primary school students in the Solomon Islands.Ī total of 604 primary school students (280 males, 324 females) aged 4-15 years were assessed in two primary schools (government, nongovernment) in the capital city Honiara.

Tuning fork hearing test