Audiologic manifestations in fetal alcohol syndrome assessed by brainstem auditory-evoked potentials

In 29 of 36 children with fetal alcohol syndrome brainstem auditory-evoked potentials were performed and the auditory threshold was determined. The hearing of patients with a pathologic finding was then subject to a thorough ear-nose-throat examination. Additionally the IQ was determined and an audiolinguistic examination was carried out. Seventy-five % of the children showed a peripheral hearing disorder on the basis of conductive hearing loss. In two children (7%) sensorineural hearing loss was located to the inner ear. A dysfunction of the auditory pathway was found in 6 patients (21%). The results of an isolated ear-nose-throat examination in 7 further children supported these findings. The mean performances in the linguistic tests were far below average and displayed a strong relation to the IQ. This study shows that a peripheral hearing disorder, especially an obstruction of the auditory tube as well as dysfunctions of the inner ear and the central hearing pathway, are different manifestations of the fetal alcohol syndrome. An etiologic connection between craniofacial abnormalities in these children and an increased susceptibility to peripheral hearing disorders could not be demonstrated. To avoid a retardation of the linguistic development in addition to the intellectual deficits a strong emphasis must be put on an early and comprehensive auditory examination of children with FAS.