[Acute perceptive hearing loss. Importance of tuning fork test in primary care]

A 56-year-old woman presented with acute right-sided hearing loss. At first presentation she was diagnosed as having otitis media with effusion. No tuning fork test was performed. After four weeks she was finally correctly diagnosed as having a right-sided sensorineural hearing loss of 90 dB. As a result of the delay no treatment was started. Her hearing loss did not show any improvement after three months. Sensorineural hearing loss is a rare, potentially invalidating condition with a considerable psychological impact. The treatment consists of systemic steroids, which may only be useful if started within 14 days after symptoms start. Some patients are initially treated for conductive hearing loss. Routine performance of the tuning fork test helps in differentiating between conductive and perceptive hearing loss. In cases of acute perceptive hearing loss, patients should be referred to the otorhinolaryngologist to exclude possible causes and start treatment and guidance.