The virtual audiometer (VA) is a software application that simulates a pure tone audiometer by delivering tones of different frequencies and intensities by air conduction.Objectives: To determine correlation between hearing thresholds measured by virtual and pure tone audiometry and degree of agreement in their hearing loss classification.Methods: Analytic, cross-sectional study set in a Philippine tertiary institution. Subjects were recruited from the outpatient department in September 2005 and comprised of cooperative, clinically normal and abnormal hearing individuals. Thirty-two subjects made 64 total ears tested (n=64), giving 0.90 correlation at 0.05 level of significance (?) (p = 0.05) and 99% power. Each subject underwent pure tone and virtual audiometry, the average thresholds calculated, and degree of hearing loss categorized according to classification by the World Health Organization (WHO). Results were not revealed until both examinations were completed. Data were stratified by frequency and compared by Pearson's correlation, while Kappa statistics determined degree of agreement betweenWHO grades of hearing impairment.Results: Average age was 40.2 years, with 20-80 year range and 18.5 years standard deviation. Nine subjects were male while 23 were female (M:F ratio = 0.39). Of 64 ears, 34 were clinically normal and 30 were abnormal. Pearson's correlation demonstrated significant positive correlation between virtual and pure tone thresholds with 99% confidence at 0.05 level of significance. Kappa statistics also showed significant degrees of agreement in WHO grades by both instruments, meaning VA will probably categorize hearing loss in the same manner as pure tone audiometry.Conclusion: A strong positive correlation exists between hearing thresholds measured by virtual and pure tone audiometry with a significant degree of agreement in hearing loss classification. This supports the possibility of using the virtual audiometer as a clinic-based, air-conduction audiometer for screening and monitoring. When used in conjunction with other examinations, valuable information on over-all integrity of the audiologic system may be ascertained.
Human ; Aged ; Middle Aged ; Adult ; Young Adult ; X

OBJECTIVES: This case report aims to (1) Present the differential diagnosis of chronic cough without neglecting uncommon causes (2) Increase awareness of diagnostic challenges that may arise in the face of a compromised airway (3) Elucidate the therapeutic complexity of airway management; (4) Emphasize the value of a multi-disciplinary team approach in such cases; Illustrate the vital role otolaryngologists play in the diagnosis and management of airway problems DESIGN: Case Report SETTING: Tertiary Care Hospital in Quezon City, Philippines PATIENTS: One Patient RESULTS: This is the case of an eleven-year old male that presented with chronic cough that was refractory to conventional empiric medical therapy. As his symptoms progressed, further evaluation revealed a mass that was obstructing a large portion of the airway. Timely and methodical investigation and intervention proved to be life-saving. CONCLUSION: A working knowledge of the differential diagnoses of chronic cough is crucial in the diagnosis and management of the compromised airway. A high index of suspicion, systematic and thorough investigation and a multi-disciplinary approach are vital components of the treatment plan. Bronchoscopy in the hands of a skilled practitioner is still a diagnostic and therapeutic mainstay. (Author)
CASE REPORTS [PUBLICATION TYPE]