The determination of the etiology of deafness due to obstruction to the conduction of sound is a comparatively simple matter to one skilled in the use of the differential tuning fork tests and experienced in the clinical course and diagnosis of the conditions which may cause deafness based on poor conduction. On the one hand are the cases of catarrhal or suppurative otitis media in which the defect in hearing is not progressive except during the active stage, i. e., an acute tubal occlusion with fluid in the middle ear or a purulent discharge from a perforation in the drum membrane. On the other hand are the cases of spongification of the labyrinthine capsule (otosclerosis) with primary fixation of the stapes and progressive deafness in which the drum membrane is entirely normal or shows slight scarring or thickening, the residues of otitis media in childhood unrelated to the present
SHAMBAUGH GE. SYNDROME OF DIPLACUSIS AND NERVE DEAFNESS FOR LOW TONES. Arch Otolaryngol. 1935;21(6):694–702. doi:10.1001/archotol.1935.00640020709007
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