title: [Hypoacusis after the neonatal period. Situations requiring hearing assessment].
abstract: BACKGROUND
  Because hearing plays a major role in language development, pediatric hypoacusis is especially damaging. The high frequency of hearing impairment in newborns and the need for an early diagnosis have led to the establishment of neonatal screening. Nevertheless, there are other situations which may compromise hearing quality in later stages and it is essential to identify them in order to be able to provide early and effective treatment.
  
  
  OBJECTIVE
  To describe the most frequent reasons for referring patients for hearing evaluation to a third level hospital and to identify common situations that require hearing assessment among the pediatric population.
  
  
  METHODS
  The clinical histories of 197 non-neonates evaluated for hypoacusis were reviewed. Clinical parameters and diagnosis were compared in patients with impaired and normal hearing.
  
  
  RESULTS
  One hundred sixty-one patients had no previous known hypoacusis. The main reason for evaluation was suspicion by the family or child minder (53.4 %), followed by language underdevelopment. In the first examinations 78 children had hypoacusis (48.4 %), which was more frequently bilateral than unilateral. In 29.5 % of hypoacusic patients, the disease was related to recurrent otitis or adenoiditis and in 25.6 % it was genetic. The most frequent antecedent was deaf relatives in hypoacusic patients and abnormal phenotypes in children with normal hearing. Three patients with previous bacterial meningitis were studied and two of these had hypoacusis.
  
  
  CONCLUSIONS
  Hypoacusic evaluation outside the context of newborn screening is mainly motivated by clinical suspicion of hypoacusis or language underdevelopment. Other situations such as recurrent otitis with effusion, syndromic phenotypic characteristics or bacterial meningitis are related to hearing problems and therefore require detailed evaluation.
authors.affiliation: Departamento de Pediatría, Centro Materno-Infantil. Hospital Universitario Central de Asturias, Oviedo, Spain. josedahm@yahoo.es
authors.forename: J D
authors.initials: JD
authors.lastname: Herrero-Morín
authors.forename: J A
authors.initials: JA
authors.lastname: Concha Torre
authors.forename: N
authors.initials: N
authors.lastname: Fernández González
authors.forename: M
authors.initials: M
authors.lastname: Crespo Hernández
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D034381:Hearing Loss / Q000175:diagnosis* / Q000209:etiology*; D006320:Hearing Tests; D006801:Humans; D007223:Infant; D008297:Male