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.