Parving A
Int J Pediatr Otorhinolaryngol. 1983 Apr;5(2):151-65. doi: 10.1016/s0165-5876(83)80020-2.
A total of 117 children, 55 girls and 62 boys with a median age of 8 years, range 2-12 years, was retrospectively evaluated in consideration of: (1) the prevalence rate and characteristics of permanent hearing loss (defined as the average of 500, 1000 and 2000 Hz greater than or equal to 35 dB HL on the better hearing ear); (2) the aetiology of the hearing impairment; (3) the basis for the aetiological diagnosis in the individual child, and (4) the value of non-audiological investigations. The overall prevalence of permanent hearing loss was 1.4% in this geographical area (children with recurrent episodes of serous otitis media are excluded). In 91% (106/117) the hearing loss was sensorineural, in 4% (5/117) conductive and in 5% (6/117) mixed conductive/sensorineural. In 63% (74/117) the hearing loss had been confirmed and assessed at the age of 3 years, while in 31% (37/117) the hearing loss was ascertained after the age of 3 years. 85% (99/117) were considered to suffer from congenital/early acquired hearing loss. The aetiology of hearing impairment could be assessed in 73% (85/117) of the children, while 27% (32/117) were diagnosed as 'unknown aetiology'. In 48% (56/117) combined audiological/non-audiological investigations had been performed, resulting in a known aetiology in 86% (48/56). In 52% (61/117) only audiological examination had been performed, resulting in a known aetiology of 61% (37/61). A significant difference (P less than 0.005) in known aetiology between these two groups is present, indicating that additional non-audiological evaluation is of decisive importance in the aetiological assessment of hearing impairment. Based on the present and previous investigations, a routine examination programme is proposed directed towards a systematic evaluation of the symptom of hearing loss and its aetiology with due caution to the individual child. The evaluation should be based on a combination of audiological/non-audiological examinations, which includes a broad interdisciplinary cooperation that preferably should be performed at diagnostic assessment centers.
对117名儿童进行了回顾性评估，其中55名女孩，62名男孩，中位年龄为8岁，年龄范围在2至12岁之间，评估内容包括：(1)永久性听力损失的患病率和特征（定义为较好听力耳的500、1000和2000赫兹平均听阈大于或等于35分贝听力级）；(2)听力障碍的病因；(3)个体儿童病因诊断的依据；(4)非听力学检查的价值。该地理区域永久性听力损失的总体患病率为1.4%（排除患有复发性浆液性中耳炎的儿童）。91%（106/117）的听力损失为感音神经性，4%（5/117）为传导性，5%（6/117）为混合性传导/感音神经性。其中63%（74/117）的听力损失在3岁时得到确诊和评估，而31%（37/117）的听力损失在3岁以后才被确定。85%（99/117）被认为患有先天性/早期获得性听力损失。73%（85/117）的儿童听力障碍病因可评估，而27%（32/117）被诊断为“病因不明”。48%（56/117）的儿童进行了听力学/非听力学联合检查，其中86%（48/56）病因明确。52%（61/117）的儿童仅进行了听力学检查，病因明确的占61%（37/61）。这两组在已知病因方面存在显著差异（P小于0.005），表明额外的非听力学评估在听力障碍的病因评估中具有决定性意义。基于目前和以往的研究，提出了一个常规检查方案，旨在对听力损失症状及其病因进行系统评估，并对个体儿童给予应有的关注。评估应基于听力学/非听力学检查的结合，这需要广泛的跨学科合作，最好在诊断评估中心进行。
