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Otoscopy
Direct examination of the external canal and tympanic membrane (ear drum) with an otoscope, a medical device inserted into the ear canal that uses light to examine the condition of the external ear and tympanic membrane, and
middle ear through the semi-translucent membrane. Differential testing
Differential testing is most useful when there is unilateral hearing loss, and distinguishes conductive from sensorineural loss. These are conducted with a low frequency tuning fork, usually 512 Hz, and contrast measures of air and bone conducted sound transmission. Weber test, in which a tuning fork is touched to the midline of the forehead, localizes to the normal ear in people with unilateral sensorineural hearing loss. Rinne test, which tests air conduction vs. bone conduction is positive, because both bone and air conduction are reduced equally. less common Bing and Schwabach variants of the Rinne test. absolute bone conduction (ABC) test.Table 1. A table comparing sensorineural to conductive hearing loss

Other, more complex, tests of auditory function are required to distinguish the different types of hearing loss. Bone conduction thresholds can differentiate sensorineural hearing loss from conductive hearing loss. Other tests, such as oto-acoustic emissions, acoustic stapedial reflexes, speech audiometry and evoked response audiometry are needed to distinguish sensory, neural and auditory processing hearing impairments. Tympanometry
A tympanogram is the result of a test with a tympanometer. It tests the function of the middle ear and mobility of the eardrum.
Progressive osseous heteroplasia is a cutaneous condition characterized by cutaneous or subcutaneous ossification.According to the Progressive Osseous Heteroplasia Association:

Progressive Osseous Heteroplasia (POH) is a rare genetic condition in which the body makes extra bone in locations where bone should not form. Extra bone develops inside skin, subcutaneous tissue (fat tissue beneath the skin), muscles, tendons, and ligaments. This ”out of place extra bone formation” is commonly referred to as heterotopic ossification. In people with POH, nodules and lace-like webs of extra bone extend from the skin into the subcutaneous fat and deep connective tissues, and may cross joints. Extra bone formation near the joints may lead to stiffness, locking, and permanent immobility.”
It is associated with GNAS.A telltale symptom of POH is osteoma cutis under the skin of a newborn. It was discovered in 1994 by physician Frederick Kaplan. Diagnosis
Patients with POH have a distinctly different manifestation of symptoms than those with fibrodysplasia ossificans progressiva (FOP), though heterotopic ossification appears in both diseases. They lack the congenital abnormality of the big toe that is a diagnostic feature for FOP. People with POH also have ossification of the skin during infancy, which does not occur in FOP. Also, the pattern of ossification differs in POH, spreading in an intramembranous fashion rather than endochondral. See also
Fibrodysplasia ossificans progressiva
Punctate porokeratosis
List of cutaneous conditions
Pseudopseudohypoparathyroidism

References


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