INTRODUCTION
Patient history, physical examination, audiological, radiological, and other laboratuary tests have an important place in ENT diagnosis. The diagnostic value of these tests varies according to the pathology. For example, otoscopic examination and tympanometric findings in middle ear infections [1,2], patient history in Menieré’s disease (MD) [3], auditory brainstem response (ABR) test in auditory neuropathy spectrum disorder (ANSD) [4), and radiological findings in cerebellopontine angle tumors For example, otoscopic examination and tympanometric findings in middle ear infections [1,2], patient history in Menieré’s disease (MD) [3], auditory brainstem response (ABR) test in auditory neuropathy spectrum disorder (ANSD) [4], and radiological findings in cerebellopontine angle tumors play an important role in diagnosis. For this reason, ENT physicians are expected to have knowledge and experience in evaluating different tests and interpreting them together to decide on a patient’s diagnosis.
The diversity of testing methods prompts ENT physicians to cooperate with healthcare professionals in different disciplines, such as audiology, radiology, hematology, neurology, and oncology. Drawing up information from these various fields for one patient is crucial to diagnose the problem correctly. Detection of the pathology is the responsibility of the ENT doctor. However, the test results obtained from the disciplines for which consultation is requested draw attention to possible pathologies, which will help the diagnosis to be fast and reliable.
Hearing tests are among the tools most commonly used by ENT physicians in the diagnosis process. Hearing test batteries play an essential role in distinguishing diseases with similar auditory configurations (e.g., MD, Superior Semisircular Canal Dehiscence (SSCD), and otosclerosis) and in the diagnosis of diseases that do not provide overt symptoms on otoscopic examination (e.g., third window syndromes (SSCD) and ANSD). Audiological tests are also indispensable in hearing aid and auditory implant decisions.
The type of hearing loss (sensory-neural, mixed or conductive) is usually emphasized in the reporting of the audiological tests. Although the type of hearing loss is an important finding, it is not sufficient to understand the pathology. For example, the expression “sensory neural hearing loss” indicates that the pathology is in the cochlea or the auditory nerve [5]. However, this expression may indicate many pathologies such as MD, acoustic trauma, presbycusis, or vestibular schwannoma. The scope of the definition of “mixed hearing loss” is much broader: it includes multiple pathologies starting from the outer ear and extending to the brain stem [5]. Therefore, audiological reports limited to specifying the type of hearing loss may cause inadequacy in diagnosing the pathology.
Mortality and morbidity rates seen in ENT clinics due to human factor errors have been demonstrated in various studies after 2004 [6,7,8]. The source of errors has been determined as diagnostic, treatment, surgical, communication, and administrative components [6]. In the same study, the ratio of errors resulting from the execution and evaluation of diagnostic tests to total errors was 10.4%. However, those studies did not specify the role of audiological tests in diagnostic illusion.
Our study aims to investigate to what extent audiological findings solely guide ENT physicians in determining pathology when other essential diagnostic tools (history, physical examination, radiologic test, etc.) are absent.