Aetiological diagnosis in hearing-impaired children--clinical value and application of a modern examination programme.

The clinical value and applicability of an examination programme aimed at identification and diagnosis of hearing loss was investigated. A total of 32 children born during the period 1970-1980 with a permanent hearing loss greater than or equal to 35 dB HL was subjected to both audiological and non-audiological test procedures, included in the examination programme. The criterion for selection of the children was hearing impairment of unknown aetiology. Based on the examination procedures, an aetiological/nosological classification could be obtained in 63% (20/32) of the children, while the aetiology remained unknown in 37% (12/32). When incorporating these data in the data of a previous epidemiological investigation an aetiological classification could be established in 89% (105/117). The present investigation demonstrates that extensive interdisciplinary cooperation with physicians outside the field of audiology is necessary for the aetiological diagnosis of hearing impairment in childhood. However, extensive interdisciplinary cooperation meets with severe practical problems. These may be overcome by the establishment of assessment centres at which trained physicians can examine and discuss the individual hearing-impaired child, and in addition exchange information from their own disciplines. Thus, more precise and valid data on the aetiological factors of hearing impairment may be obtained and in addition preventative methods taken into account. In this way a reduced prevalence of hearing impairment in childhood may be achieved.