ENT · Hearing Assessment (Audiometry, Tuning Fork Tests, ABR)

A patient with clinical otosclerosis undergoes Gelle's test. A Siegel's pneumatic speculum is used to alternately compress and decompress the ear canal while a tuning fork is held on the mastoid process. The patient reports NO change in the loudness of bone-conducted sound with pressure changes. What does this indicate?

  • A Mobile stapes footplate; otosclerosis is unlikely
  • B Ossicular discontinuity
  • C Fixed stapes footplate; consistent with otosclerosis
  • D Eustachian tube dysfunction
Correct answer: C. Fixed stapes footplate; consistent with otosclerosis

Explanation

Gelle's test assesses stapes mobility. A positive (normal) test shows a change in loudness with pressure changes (mobile stapes). A negative Gelle test (no change in loudness with pressure) indicates a fixed stapes footplate, consistent with otosclerosis. This test helps differentiate otosclerosis from ossicular discontinuity or Eustachian tube dysfunction.

Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery, 7th ed.

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