Serville M N, Demanez L, Demanez J P
Department of Otorhinolaryngology, Head and Neck Surgery, Université de Liège, CHU Sart Tilman, Liège, Belgium.
Acta Otorhinolaryngol Belg. 2004;58(1):53-9.
In a retrospective study based on parents' personal interviews, the diagnosis circumstances were analysed in a group of 88 deaf children (moderate to profound deafness). We reported first the age when the parents emitted doubts, and second the age of diagnosis. It appeared that the age of first suspicions, and of diagnosis, was correlated to the degree of deafness. The population of children was divided in two groups depending on the presence of a delay or not in the diagnosis. The first group (24 children) was diagnosed early because of neonatal screening, or of early suspicions by parents or pediatrician. In the second group (64 children) were a delay was observed, seven causes were identified with variable frequency according to the level of deafness. The first four main causes for delayed diagnosis were: 1) parents, 2) medical refutation, 3) otitis media with effusion (OME), 4) progressive hearing loss. In conclusion, the age of diagnosis and the age of first suspicions were too late. Universal neonatal screening is recommended but do not appear to be the exclusive procedure to reduce the diagnostic's delay. This analysis of the factors of delay, prompted us to recommend: 1) information to parents on deafness, 2) careful attention to parents suspicions, 3) an objective evaluation of auditory function,especially after OME cure and 4) a follow-up of children to identify progressive hearing loss.
在一项基于对家长进行个人访谈的回顾性研究中，对一组88名聋儿（中度至重度耳聋）的诊断情况进行了分析。我们首先报告了家长开始产生疑虑的年龄，其次报告了诊断年龄。结果显示，首次产生怀疑的年龄和诊断年龄与耳聋程度相关。根据诊断是否存在延迟，将儿童群体分为两组。第一组（24名儿童）因新生儿筛查、家长或儿科医生早期怀疑而被早期诊断。在第二组（64名儿童）中观察到存在延迟诊断情况，根据耳聋程度不同，确定了七种频率各异的原因。延迟诊断的前四个主要原因是：1）家长，2）医学上的否定，3）中耳积液（OME），4）进行性听力损失。总之，诊断年龄和首次产生怀疑的年龄都太晚了。建议进行普遍的新生儿筛查，但这似乎并非减少诊断延迟的唯一方法。对延迟因素的这一分析促使我们建议：1）向家长提供有关耳聋的信息，2）认真关注家长的怀疑，3）对听觉功能进行客观评估，尤其是在OME治愈后，4）对儿童进行随访以发现进行性听力损失。
