The management of pseudohypacusis in school-age children

Pseudohypacusis is a condition in which there is an apparent hearing loss in the absence of clinical or audiological evidence; indeed, audiological assessment for inconsistencies is the mainstay of diagnosis. It is easier to diagnose in children than in adults, due to a child's inability to produce consistently similar results on repeat tests. We have reviewed 15 children with pseudohypacusis, who had an average loss in the right ear of 57 dB, and of 59 dB in the left ear when tested by pure tone audiometry. Eight children were diagnosed by clinical impression and inconsistent pure tone audiograms but in order to confirm the diagnosis in the other seven children further testing with a speech audiogram was necessary and proved sufficient to establish the diagnosis in all cases. The hearing of all 15 children resolved spontaneously at between 2 and 70 months, when treated by careful monitoring and supportive therapy, and none of the children needed psychiatric referral.