Objective:Hearing loss is a prevalent disease with free field voice test (FFVT) being a common hearing test performed.FFVT has its own disadvantage as screening tool as there is no standardization of speech among examiners.We aim to invent mobile-app based hearing screening using Flutter-Dart programming language that mimics findings of FFVT.The app is termed as Free field click test (FFCT).Our aim is to compare sensitivity&specificity of FFCT and FFVT with Pure Tone audiogram (PTA).Methods:This is an open-labelled randomized controlled trial. This study was conducted in a sound proof room in our ORL clinic from December-March 2020. 50 patients from 18-80 years old with complaint of hearing loss were recruited.These patients were randomly assigned into two groups; FFVT&FFCT which were compared with PTA.Categorical data were analyzed with Chi-square test,non-categorical data were calculated with Student t-test for statistical significance.Results:Results were calculated based on degree of hearing loss against PTA.FFCT‘s rate of detection of hearing loss was significant for all degrees of hearing loss with p-values of <0.05. FFVT’s detection rate was only significant to normal hearing, moderate & severe hearing loss. FFCT had higher sensitivity of 94.1% for normal hearing compared to 52% for FFVT.FFVT had higher specificity but with a marginal difference only.A higher rate of accuracy (94%) and strength of the correlation (0.97) were obtained for FFCT than FFVT.Conclusion:FFCT is a more sensitive&accurate tool than FFVT in detecting hearing thresholds. It proves to be an ideal tool to screen hearing loss and is convenient in times of social distancing during COVID-19 pandemic now.

Mucoepidermoid carcinoma (MEC) accounts for only 5% of all salivary gland tumors and is most often seen in the parotid glands. MEC occurrence in the larynx is, however, rare. The incidence of primary squamous cell carcinoma (SCC) of salivary glands is also scarce and comprises only about 1.6% of all salivary gland malignancies. Hereby, we share our experience in managing two patients with rare and opposite variants of malignancy which were diagnosed at the same time; MEC of the larynx and SCC of the parotid. In MEC tumors, the presence of the intermediate and mucous cells with positivity in mucicarmine stain are the significant features. For SCC tumors, identification of the usual tumor markers (p40, CK 5/6 and p63) are pathognomonic. Although MEC and SCC are common in the head and neck regions, the existence of these malignancies in exceptional locations must be considered. The key features mentioned in our comparison table can help distinguish both these tumors and to deliver the correct treatment modalities. The prevalence of genomic and carcinogenic factors in the occurrence of these tumors in uncommon locations needs to be explored in future studies.