A 28-year-old woman presents with progressive bilateral hearing loss. On tuning fork tests, Rinne test is negative on both sides at 512 Hz, and Weber test lateralizes to the right. Gelle test is absent on the right. Which finding best explains the absent Gelle test?
- A Fixation of the stapes footplate preventing movement of the tympanic membrane on pneumatic pressure ✓
- B Discontinuity of the ossicular chain dampening ossicular vibration
- C Perforation of the tympanic membrane equalizing pressure across the membrane
- D Middle ear effusion absorbing pneumatic pressure changes
Correct answer: A. Fixation of the stapes footplate preventing movement of the tympanic membrane on pneumatic pressure
Explanation
The Gelle test assesses mobility of the malleus-ossicular chain by applying pressure via the pneumatic speculum and observing movement of the tympanic membrane. In otosclerosis, stapes fixation prevents this movement, making the test absent. This is a classic bedside finding in otosclerosis that helps differentiate it from ossicular discontinuity (where the test may be present) or middle ear effusion.
Reference: Diseases of Ear, Nose and Throat & Head and Neck Surgery, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.