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Can smartphone vibration provide a valid alternative to tuning forks for use on the ENT ward round?

  • M E Hopkins (a1) and D Owens (a1)

All patients undergoing tympanomastoid surgery should be assessed post-operatively for a ‘dead ear’; however, tuning forks are frequently inaccessible.


To demonstrate that smartphone-based vibration applications provide equivalent accuracy to tuning forks when performing Weber's test.


Data were collected on lay participants with no underlying hearing loss. Earplugs were used to simulate conductive hearing loss. Both the right and left ears were tested with the iBrateMe vibration application on an iPhone and using a 512 Hz tuning fork.


Occluding the left ear, the tuning fork lateralised to the left in 18 out of 20 cases. In 20 out of 20 cases, sound lateralised to the left with the iPhone (chi-square test, p = 0.147). Occluding the right ear, the tuning fork lateralised to the right in 19 out of 20 cases. In 19 out of 20 cases, sound lateralised to the right with the iPhone (chi-square test, p > 0.999).


Smartphone-based vibration applications represent a viable, more accessible alternative to tuning forks when assessing for conductive hearing loss. They can therefore be utilised on the ward round, in patients following tympanomastoid surgery, for example.

Corresponding author
Author for correspondence: Mr Michael E Hopkins, ENT Department, Lauriston Place, Edinburgh EH3 9EN E-mail:
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Mr M E Hopkins takes responsibility for the integrity of the content of the paper

Presented as a poster at the British Association of Otorhinolaryngology (‘BACO’) meeting, 4–6 July 2018, Manchester, UK.

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1Buckland, JR, Geyer, M, Maleki, N, Mitchell, TM. The use of Weber tuning fork test and ‘scratch test’ in postoperative tympanomastoid surgery. Clin Otolaryngol 2006;31:581
2Iacovidou, A, Giblett, N, Doshi, J, Jindal, M. How reliable is the “scratch test” versus the Weber test after tympanomastoid surgery? Otol Neurotol 2014;35:762–3
3Miltenburg, D. The validity of tuning fork tests in diagnosing hearing loss. J Otolaryngol 1994;23:254–9
4Stankiewicz, JA, Mowry, HJ. Clinical accuracy of tuning fork tests. Laryngoscope 1979;89:1956–63
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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