都城鍼灸ジャーナル

宮崎県都城市で鍼灸師をしている岩元英輔(はりきゅうマッサージReLife)です。読んだ論文を記録するためのブログです。当院のホームページ https://www.relife2019.jp/index.html しんきゅうコンパス https://www.shinq-compass.jp/salon/detail/33749

突発性感音難聴のウェーバーテストの精度

2021 Feb 13;1-4.
 doi: 10.1080/00016489.2021.1881614. Online ahead of print.

Weber test accuracy in sudden sensorineural hearing loss: which frequency is best?

 
Acstractのみ
突発性難聴ガイドラインにおいて、ウェーバーテストは推奨されているが、最適な周波数は明らかにされていない。
そこで、感度の高い周波数を特定し、その精度は?
 
500Hzが最も感度が高い;94.49(90.76-97.03)%
500と1000では有意差なし。
1000と2000で有意差あり。
 
使用は512か1024Hzのものを用いるといい。

Background: Recent guidelines encourage the use of Webet test (WT) as a part of the physical examination of a newly suspected sudden sensorineural hearing loss (SSNHL) patient. However, the most sensitive tuning-fork frequency has never been identified.

Objective: To identify the most sensitive frequency for initial WT of patients with suspected SSNHL.

Methods: Medical records of patients with confirmed SSNHL, who underwent formal audiometry in which the WT was carried out with different frequencies were analyzed.

Results: 319 medical records were identified. The most sensitive WT frequency was 500 Hz, with a sensitivity of 94.49% (223/236. confidence interval 90.76-97.03). There was a non-significant difference between 1000 Hz EBO and 500 Hz EBO (p = .1655), a tendency towards a significant difference between 1000 Hz EBO and 2000 Hz EBO (p = .0578), and a significantly better sensitivity than the 4000 Hz EBO (p = .0163).

Conclusion: The most sensitive WT frequency for SSNHL diagnosis is 500 Hz. However, the sensitivity of this frequency is 94.49%.

Significance: 512 or 1024 Hz should be used to better identified SSNHL. Even WT lateralization to the affected ear, does not preclude the diagnosis of SSNHL. Formal audiometry should be used in any case of medical history suspected for sudden hearing loss with normal otoscopy.

Keywords: Hearing loss; Weber test; sudden sensorineural hearing loss; tuning fork.

 

現在当院では、音叉がないので、そのうち購入しようと思ってます。

今回の報告では、感度のみ記載がありますが、特異度はどうだったのでしょうか?

今は、指こすり音とタップ音を身体所見では活用しています。