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Differential Diagnosis for Not Hearing Vibration on Web Test

  • Single Most Likely Diagnosis
    • Conductive Hearing Loss: This is the most likely diagnosis because the web test, also known as the Weber test, is used to lateralize sound. If a patient does not hear the vibration, it could indicate a problem with sound conduction, which is a hallmark of conductive hearing loss.
  • Other Likely Diagnoses
    • Sensorineural Hearing Loss: Although less likely than conductive hearing loss to cause a negative web test, significant sensorineural hearing loss could affect the perception of vibrations, leading to a false negative result.
    • Middle Ear Effusion: Fluid in the middle ear can dampen sound and vibration, potentially leading to a negative test result.
  • Do Not Miss Diagnoses
    • Otosclerosis: A condition that affects the middle ear, leading to conductive hearing loss. It's crucial to diagnose because it can be treated surgically.
    • Acoustic Neuroma: A rare tumor on the nerve connecting the inner ear to the brain. Although unlikely, missing this diagnosis could have severe consequences, including hearing loss and neurological deficits.
  • Rare Diagnoses
    • Ototoxicity: Certain medications or chemicals can damage the ear, leading to hearing loss. This could potentially affect the results of the web test, although it would be an uncommon cause.
    • Superior Semicircular Canal Dehiscence: A rare condition where there is an abnormal opening in the bone overlying the superior semicircular canal of the inner ear. It can cause conductive hearing loss and altered sound perception, potentially affecting the web test results.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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