Hipoacusia de conducción en hidropesia endolinfática / Conduction deafness in endolymphatic hidropesy

The audiograms of 33 patients suffering from Méniére's disease were studied. A conductive hearing loss was found in about fifty per cent of then. The following criteria was used to consider that a patient had a conductive hearing loss: First, an air-bone gap of at least 20 dB in one frequency, excluding 250 Hz. If in 250 Hz there is an air-bone gap of 20 dB, it is necessary an addtional air-bone gap in other frequency of at least 10 dB. Second, when an air-bone gape of 15 dB exists in one frequency, it must be another air-bone gap of at least 10 dB in other frequency. These conditions must be found in two or more audiograms in the same patient. Two groups were made with the 33 patients. One was conformed by 24 patients that had one or more of the following conditions: 1. A positive glucrol test. 2. Fluctuating hearing loss. It means that the patinte had an improved audiogram in respect to a previous one. 3. An ascending profile in the low frequencies. 3. An ascending profile in the low frequencies. The second group of nine patients had not any of the previous chacracteristics. In the first group the authors found that 62.5% had a conductive hearing loss while in the second group 22.2% had the same condition. This difference is statistically significant (p = 0.05). Nine impedanciometric test belonging to eight of the first group and three of equal number of patients of the second group were analyzed. Only few cualitative changes in the tympanometric curve were found. Five of the eight patients of the first group and none of the three patients of the second group showed an increase of the static compliance

Consideraciones sobre la prueba de Fowler / Fowler test

Se realizó la prueba de Fowler (ABLB) a 37 sujetos, otológica y audiológicamente normales, a los que se provocó una hipoacusia de transmisión unilateral mediante la inserción de un protector auditivo. Lo mismo se efectuó en 26 pacientes portadores de una otitis media crónica unilateral en que se condicionó qu el umbral para la vía ósea del oído afectado fuera de 15 dB o menos. Se encontró, según el criterio empleado, porcentajes variables de pruebas con reclutamiento positivo. Consideramos estos porcentajes como falsos positivos. Pensamos que la prueba de Fowler, así como cualquiera otra prueba clínica, es sugerente de lesión coclear pero no excluyente de lesión neural. Por ello nos permitimos recomendar que a pesar que algunas pruebas audiométricas indiquen lesión sensorial, debe completarse el examen con las pruebas de deterioro tonal o fatiga auditiva