PubMed · 8855050
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K M Lankin. 1996. Audiogram consistency needed.. https://pubmed.ncbi.nlm.nih.gov/8855050/
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In developing countries with limited no or access to standard audiometric methods a 'voice test' is a potential non-technological alternative method of assessing hearing. A three level 'voice test' was developed, refined and standardised-accurate response to a whispered voice equating with normal hearing, to a conversational voice with mild hearing loss and to a loud voice to moderate/severe hearing loss. In a hospital based study 177 children were voice tested in sound treated rooms and then tested using standard audiometric procedures to determine precise hearing thresholds. In this situation the voice test had a specificity of 95.9% and a sensitivity of 80%. When the test was evaluated on 201 children aged 3-8 years, first voice tested and then tested with standard audiometry in the classrooms of their pre-primary schools it was found to have a specificity of 97.8% and a sensitivity of 83.3%. With this degree of accuracy in detecting hearing impairment and given the simplicity required to administer the test, it is felt that such a test could be recommended for use by primary health care workers in developing countries where access to standard audiometric methods for assessing hearing are not available.
An enlarged vestibular aqueduct is a congenital disorder causing early onset and progressive hearing loss in children. This paper presents the audiological findings at first presentation and the audiological evolution in 10 consecutive cases presenting with hearing loss and showing a large vestibular aqueduct on imaging. The reported onset of the hearing loss is within the first few years of life. Most of the cases (80%) showed bilateral involvement. The sex ratio was 1. Patients presented on average at age 5 with a median hearing loss of 62 dB at the speech frequencies. The hearing loss was essentially asymmetrical with an interaural difference, of 33 dB and it was a mixed type of hearing loss in 90% of the cases. The authors claim that the conductive component of this hearing loss is a pure cochlear conductive loss which may be pathognomonic for the disease. The presence of a conductive component in a child is easily misinterpreted as a middle ear ventilation problem or in case of good ventilation as an ossicular problem (type otosclerosis). In addition and in contrast to most literature data, the authors did not find evidence for stabilization of the hearing loss but they found a steady decrease of the hearing at an average rate of 4 dB/year.
BACKGROUND: impaired ability to detect target sounds in noisy surroundings is a particular feature of children with a history of otitis media with effusion (OME). Children with current OME are also likely to experience difficulty in speech reception in classrooms where a high level of background noise has been recorded. No tests are currently available which are feasible in primary care and which objectively measure school-related disabilities. The effects of speech in noise and the extent to which this is offset by speech reading contribute important dimensions to disability. METHODS: a video-based speech reception test has been developed using the same principles in 227 English and 182 Danish 4-8 year-old children. Distribution data was collected for both language versions of the test. The test has been compared with audiometry and teacher and parents assessments to establish its validity. INTERPRETATION: there are no gold standards for audio-visual disability in current clinical use. The poor positive predictive value of audiometry for likely classroom functioning is a cause for concern, particularly in relation to inappropriate referral of children by primary care physicians.