| Abstrakt: |
A study of otologic and audiologic screening of preschool children including tympanometry, acoustic reflexes, and pure-tone screening was carried out at school sites. Subsequent pure-tone threshold tests and otolaryngologic examinations were carried out in a hospital setting. Complete data are available on 1,335 subjects, ages 3 through 5 years. Results are reported in comparison with those of an earlier Pittsburgh screening study. The results of the earlier study showed that loss of hearing sensitivity could not be predicted by the otologic findings, and conversely, the otologic findings could not be predicted by the air conduction thresholds. The results of the present study showed a contribution by tympanometry and acoustic reflexes. The results are evaluated in terms of screening effectiveness in these age groups. One of the recommendations combines an interpretation of certain large negative tympanometric peak pressures (TPP) along with the absence of acoustic reflexes to certain stimuli. The method is more efficient than other aspects of middle ear measurement or of pure-tone screeniing. The efficiency of each procedure is documented. Summary matrices are used to show the effectiveness of each test compared to all other tests in the identification of subjects with hearing or middle ear dysfunction. A protocol for screening evaluation and otologic referral is suggested to effect a balance between over-referral and correct identification. |
