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Childhood pseudohypacusis
J P Pracy1, R M Walsh, G A Mepham
1Department of Otolaryngology, Head and Neck Surgery, Lewisham General Hospital, London, UK.
Insights
Pseudohypacusis, or non-organic hearing loss, is often missed in children. Consistent audiological testing is key to diagnosis, with most cases resolving with support.
Area of Science:
- Audiology
- Pediatrics
- Otolaryngology
Background:
- Pseudohypacusis involves hearing loss without organic cause, often diagnosed by inconsistent audiological test results.
- Diagnosis is typically easier in children, yet frequently overlooked due to lack of awareness.
Purpose of the Study:
- To present findings on pseudohypacusis in ten pediatric patients.
- To highlight diagnostic challenges and outcomes in children with suspected non-organic hearing loss.
Main Methods:
- Review of audiological test results (pure tone and speech audiometry) in ten children.
- Analysis of diagnostic consistency and follow-up outcomes.
Main Results:
- Speech audiometry confirmed pseudohypacusis in nine out of ten children.
- One child had a confirmed sensorineural hearing loss, initially masked by pseudohypacusis.
- Nine children showed normal hearing thresholds after intervention; one improved to match the sensorineural loss.
Conclusions:
- Pseudohypacusis is a significant diagnostic consideration in pediatric audiology.
- Careful audiological assessment and consistent follow-up are crucial for accurate diagnosis and management.
- Non-organic hearing loss in children often resolves with appropriate support and monitoring.
Abstract:
Pseudohypacusis is a condition in which a hearing loss is exhibited in the absence of any organic disease. The mainstay of diagnosis is a lack of consistency in audiological testing. It is usually easier to diagnose in children than in adults, as children are less able to produce consistently erroneous results on repeated testing. In spite of this, the diagnosis is often missed in children, probably due to a lack of awareness of the condition. We present the findings in ten children seen in the past year. Initially they had average pure tone thresholds of 51.3 db in the right ear and 51.4 db in the left ear. All of the children underwent repeat pure tone audiometry and speech audiometry. In nine cases the speech audiograms confirmed the diagnosis. In one child the speech audiogram was consistent with a mild hearing loss subsequently confirmed as a 30-40 db low frequency sensorineural hearing loss. Following a programme of close follow up and support, the pure tone thresholds returned to within normal limits in nine children and to a level consistent with the clinical impression in the child with a sensorineural loss. None of the children required brain stem evoked response audiograms to confirm the diagnosis.