title: Appropriate hearing screening in the pediatric patient with head trauma.
abstract: OBJECTIVE
  To develop an algorithm for the appropriate audiologic screening of in children with head trauma.
  
  
  METHODS
  Participants were the first consecutive 50 children admitted to a children's hospital trauma service after October 1, 2005, whose injuries resulted in a Glasgow Coma Scale (GCS) score ≤13 and/or loss of consciousness (LOC) but no history of hearing loss. Screening tympanometry, otoacoustic emissions testing, and/or routine audiometric evaluation were performed as soon as possible after admission. Age, GCS score, Pediatric Trauma Score, Injury Severity Score, presence of head and neck soft tissue injury, temporal bone fracture, skull fracture not involving the temporal bone, midface/mandible fractures, intracranial abnormality on computed tomography, and cervical fracture were analyzed as risk factors for hearing loss.
  
  
  RESULTS
  Seventeen (34%) of the 50 children had abnormal hearing test results. Fischer's exact test showed abnormal test results were most strongly related to temporal bone fracture (p=0.0041), non-temporal bone skull fracture (p=0.0211) and younger age (p=0.0638).
  
  
  CONCLUSIONS
  Any child with head trauma and clinical or radiologic evidence of temporal bone fracture should have early hearing evaluation. Using the proposed algorithm to test children with head trauma and GCS ≤13 and/or LOC and age <3 years or any type of skull fracture may help identify children with hearing loss in a more cost effective manner.
authors.affiliation: University of Alabama, Birmingham, USA.
authors.forename: Michael K
authors.initials: MK
authors.lastname: Bowman
authors.forename: Belinda
authors.initials: B
authors.lastname: Mantle
authors.forename: Neil
authors.initials: N
authors.lastname: Accortt
authors.forename: Wenquan
authors.initials: W
authors.lastname: Wang
authors.forename: William
authors.initials: W
authors.lastname: Hardin
authors.forename: Brian
authors.initials: B
authors.lastname: Wiatrak
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D006259:Craniocerebral Trauma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D015600:Glasgow Coma Scale; D034381:Hearing Loss / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D006320:Hearing Tests / Q000379:methods*; D006776:Hospitals, Pediatric; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008297:Male; D008403:Mass Screening; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D013701:Temporal Bone / Q000293:injuries*; D014193:Trauma Centers