Childhood pseudohypacusis in patients with high risk for actual hearing loss.

Objective: While pseudohypacusis or nonorganic hearing loss is a well-recognized phenomenon in adults, it is the aim of this report to heighten the physician' awareness of the occurrence of nonorganic hearing loss in pediatric patients. The medical and otologic histories of 18 cases identified consecutively between 1983 and 1991 at The Children' Hospital, Boston, Massachusetts, were retrospectively reviewed. In these selected cases an analysis of the audiometric configuration, age range, and sex distribution is undertaken. This review highlights the need to rule out pseudohypacusis even in pediatric cases where suspicion is low. A precedent trauma was the presenting complaint in a high percentage of our patient population. This association has not been previously reported in the pediatric literature. While the severity of the traumatic incident was often minor, extensive medical and surgical investigations had been considered before the identification of nonorganic hearing loss. Study Design: A retrospective chart analysis of patients identified with pseudohypacusis over a 7-year period. Methods: A tertiary care children' hospital in an urban community. Eighteen consecutively identified patients examined by a staff audiologists at a tertiary care children' hospital. A specific battery of standard audiologic testing with the goal of detecting pseudohypacusis in children. Results: Successful if additional interventions such as exploratory tympanotomy were avoided. Conclusions: Pseudohypacusis was identified in 18 patients with a majority having an antecedent history of trauma. Additional interventions were canceled upon the detection of true threshold values. A high index of suspicion of pseudohypacusis in children and an organized standardized battery of audiologic testing will facilitate early identification of these patients and will avert inappropriate interventions. Laryngoscope, 108:1534-1538, 1998 [ABSTRACT FROM AUTHOR]