Paediatrics: how to diagnose hearing disorders in children

Hearing function disorders can currently be diagnosed with different sophisticated instrumental methods

The test most commonly requested and performed at ENT clinics is the audiometric test, which allows the degree of hearing loss to be assessed.

Simple to perform, it quickly orients the specialist on the severity of the hearing impairment and, to a certain extent, on the cause of it. In paediatrics, the most common test is the impedance test, which assesses the degree of elasticity of the tympanic membrane and the presence of mucus in the tympanic cavity.


This instrumental investigation is used to follow catarrhal disease of the middle ear, one of the most common disorders in children

Over the years, technology has allowed us to move from complex devices that allowed test times in the order of several minutes to simple, portable instruments that allow a test to be performed in seconds.

All this has allowed specialists in paediatrics to increasingly use impedance measurement in outpatient clinical practice.

This extensive use makes it possible to meticulously follow all middle ear pathology in paediatrics, avoiding even serious surgical complications that can sometimes even lead to otogenic meningitis.

Also in the paediatric field, and more specifically neonatal, acoustic oto-emissions are currently used: this is a simple and rapid method that allows, through the analysis of Kemp’s cochlear echoes, to assess the integrity at birth of the inner ear.

This method allows early diagnosis of deafness and therefore immediate prosthesisation in order to prevent hearing deprivation from minimally altering the psychophysical development of the little patient.

Other and more complex instrumental investigations are represented by the brainstem’s Evoked Potentials (ABR) and Electrocochleography (EchoG) that study, with electrophysiological methods, the nerve pathways that conduct the acoustic signal from the inner ear to the cerebral cortex.

The application of these investigations is certainly oriented towards the diagnosis of neurological hearing pathologies, i.e. the noble and delicate nerve components that can give rise to irreversible but fortunately very rare injuries.

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