A Diagnostic Paradigm for Childhood Idiopathic Sensorineural Hearing Loss
Presented at the American Society of Pediatric Otolaryngology Combined Otolaryngology Spring Meeting, Nashville, TN, May 5, 2003.
Abstract
OBJECTIVE
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).
DESIGN AND SETTING
We undertook a retrospective study of patients presenting with SNHL at our institution from 1993 to 2002.
RESULTS
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.
CONCLUSIONS
Based on diagnostic yields, we propose a cost-effective stepwise diagnostic paradigm to replace the more commonly used and costly simultaneous testing approach. EBM rating: C. (Otolaryngol Head Neck Surg 2004;131: 804–9.)
