Preschool Hearing Screening: Nineteen Years of the Coração Delta Project in Campo Maior, Portugal.

: Preschool hearing screening is justified by the risk of late onset hearing loss, the high prevalence of otitis media with effusion in school-aged children, and the critical timing just before children begin formal reading and learn to write. This study describes the results of the annual preschool hearing screening program in Campo Maior from 2007 to 2025 (nineteen years) and correlates the audiological referral to the otoscopy findings by the otolaryngologists. : Retrospective study using clinical records from nineteen years of preschool hearing screening. : Screening identified 310 children (29% of 1068 screened) requiring referral to an ENT specialist. Of the 217 referred children evaluated by ENT, 198 (91.2%) had confirmed pathology or healthcare needs of medical intervention. A statistically significant positive association (r = 0.254, < 0.05) existed between abnormal otoscopy findings and Type B or C2 tympanograms (versus Type A or C1). Hearing loss occurring with Type A tympanograms (0.8% unilaterally, 0.3% bilaterally) may suggest sensorineural hearing loss. : This study reinforces the importance of universal preschool audiological screening for all children, particularly for children facing geographic barriers to healthcare. Community-based interventions facilitated by social solidarity associations can play a crucial role in mitigating healthcare access disparities across populations.