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To the Editor.—In a recent issue of the Archives, an article was presented on the effect of degree of hearing loss on diagnostic test strategy, by Hayes and Jerger (106:266-268, 1980). The neuro-otologic examination of a patient with a suspected retrocochlear lesion involves a battery of tests including audiometric evaluation, electronystagmography, and radiologic procedures, usually computerized axial tomography using either air contrast or intravenous agents. The definitive diagnosis on occasion is made with posterior fossa myelography. Nowhere in this article does it mention the results of the other testing. The authors leave one with the impression that the diagnosis was made primarily and solely on audiometric findings.
The point is that the diagnosis of such lesions can be done only by physicians with a high index of suspicion using all of the diagnostic facilities at hand. I would hate to see a cerebellar pontine angle lesion missed because the
DASPIT CP. Diagnostic Testing. Arch Otolaryngol. 1980;106(10):655. doi:10.1001/archotol.1980.00790340063017
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