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<p class="abstract"><strong><span lang="EN-US">Background:</span></strong>Hearing loss is an invisible injury that has been viewed as an acceptable by-product of military service. It is imperative to detect hearing loss at early stage to take immediate remedial measures. In Indian armed forces the current method of assessment of hearing is primarily by Free Field Hearing which is obsolete and has numerous shortcomings. We contucted a study using free iOS application to detect hearing loss. The objectives of the study were to investigate the validity and reproducibility of app based hearing assement and free field hearing with clinical pure tone audiometer as gold standard. It is cross sectional intra-subject comparative study</p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong>The study was conducted at CHAF where 200 patients were accrued. Hearing assessment was carried out by Pure Tone Audiometry (PTA) which is gold standard. Thereafter these patients were subjected to hearing assessment by using windows application “freehearingtestsoftware.com” and by free field hearing (FFH).  </p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong>Hearing assessment by FFH and hearing check app was compared with PTA. Hearing check app was found to be more sensitive than FFH (98% and 73%). Both modalities had high specificity (95% and 99%). The test retest reproducibility measured with Pearson correlation coefficient was high (0.99) with hearing check app.</p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong>Smart phone application like Hearing check app is a cheap and effective way to assess hearing with reasonable accuracy. It’s high sensitivity and high test retest reproducibility makes it an ideal tool for screening and early detection of hearing loss replacing out-dated free field hearing.</p><p class="abstract"><span lang="EN-US"> </span></p>

Accurate prognostication of the outcome of vocal fold immobility assumes great importance in the management. This study aimed to evaluate the prognostic efficacy of Laryngeal electromyography in cases of vocal fold immobility. A nonrandomized prospective study was carried out from Sep 2009 to Jun 2011. Patients were evaluated using Fiberoptic laryngoscopy and Laryngeal electromyography over a period of 24 weeks. 51 subjects participated in the study, comprised of 22 males and 29 females. All patients underwent detailed clinical examination including Fiberoptic laryngoscopy on the first visit and Laryngeal electromyography testing on the second visit. Subsequent neuromonitoring was carried out at 04, 12 and 24 weeks from date of initial recording. Outcome measures of vocal fold motion were dichotomized into persistent vocal fold immobility (unilateral or bilateral) or resolved vocal fold motion (normal). Approximately 24 weeks after onset of palsy, mobility of the paralyzed vocal cord was restored in 31 (60.78 %) of 51 cases, while 20 (39.22 %) remained immobile. Sensitivity of laryngeal electromyography was 92.53 % ; specificity 93.33 %, positive predictive value 98.77 % and negative predictive value 68.29 %. This study confirmed the utility of Laryngeal electromyography in predicting prognosis for recovery of vocal fold motion after laryngeal nerve injury. The results supported the hypothesis that Laryngeal electromyography data can be used effectively to determine a prognosis for recovery of vocal fold motion.