1. A Diagnostic Paradigm for Childhood Idiopathic Sensorineural Hearing Loss
- Author
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John H. Greinwald, Lynne H.Y. Lim, David Myer, Louise Lawson, Daniel I. Choo, Diego Preciado, Chris Ngo, Colm Madden, Aliza P. Cohen, and John K. Bradshaw
- Subjects
Pediatrics ,medicine.medical_specialty ,Adolescent ,Hearing loss ,Cost-Benefit Analysis ,Hearing Loss, Sensorineural ,Audiology ,Severity of Illness Index ,Connexins ,Cohort Studies ,Electrocardiography ,03 medical and health sciences ,Gjb2 gene ,0302 clinical medicine ,Severity of illness ,otorhinolaryngologic diseases ,Humans ,Medicine ,Genetic Testing ,Child ,030223 otorhinolaryngology ,Retrospective Studies ,Genetic testing ,medicine.diagnostic_test ,Clinical Laboratory Techniques ,business.industry ,Infant, Newborn ,Infant ,Retrospective cohort study ,Magnetic resonance imaging ,medicine.disease ,Magnetic Resonance Imaging ,Connexin 26 ,Otorhinolaryngology ,Child, Preschool ,030220 oncology & carcinogenesis ,Surgery ,Sensorineural hearing loss ,medicine.symptom ,Tomography, X-Ray Computed ,business ,Algorithms ,Cohort study - Abstract
Our objective was to determine the diagnostic yield of laboratory testing, radiological imaging, and GJB2 mutation screening in a large cohort of patients with differing severities of idiopathic sensorineural hearing loss (SNHL).We undertook a retrospective study of patients presenting with SNHL at our institution from 1993 to 2002.Laboratory testing had an extremely low yield. Patients with unilateral SNHL had a significantly higher imaging yield than those with bilateral. The diagnostic yield of GJB2 screening was significantly higher in patients with severe to profound SNHL than in those with less severe SNHL. However, a relatively large number of patients with mild to moderate SNHL had positive GJB2 screens.Based on diagnostic yields, we propose a cost-effective stepwise diagnostic paradigm to replace the more commonly used and costly simultaneous testing approach.C.
- Published
- 2004
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