Hearing Screening: A Comparative Study of an Impedance Method and Pure Tone Screening

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Abstract
The author has previously postulated that acoustic impedance measurements might be more satisfactory than conventional pure tone screening audiometry in detecting aural disorders in young schoolchildren. In this paper are reported the results of a comparative study of pure tone screening and a combined impedance/single frequency tone test. 543 children were examined by both methods. Agreement was reached (either pass or fail) in 81.5 % of the children. The major causes of disagreement were (1) fluid in the middle ear undetected by the hearing test, but obvious by tympanometry, and (2) ‘failure’ to respond to low frequency tones on the hearing test while indicating normal function by impedance testing and normal hearing to high tones. It is suggested that further investigation of this combined approach would be worthwhile. Forfatteren har tidligere hœvdet, at undersøgelse af ørets akustiske impedans ville vœre mere tilfredsstillende end almindelig screening-audiometri til afsløring af ørelidelser has skoleelever i de yngste klasser. I denne artikel bringes resultaterne af en sammenligning mellem konventionel screening udført på 4 frekvenser (250, 1000, 2000 og 4000 Hz) og en procedure bestående af impedansmåling suppleret med screening på en enkelt frekvens (4000 Hz). Der var overensstemmelse mellem udfaldet (bestået eller ikke bestået) af de to prøver hos 51.5 % af børnene. De vœsentligste årsager til uoverensstemmelse var (1) vœdske i mellemøret, ikke erkendt ved toneaudiometri, evident ved tympanometri og (2) manglende reaktion på dybe toner ved høreprøven, skønt impedansundersøgelsen viste normal mellemørefunktion, og hørelsen for høje toner fandtes inden for det Normale. Fortsatte undersøgelser over vœrdien af kombinationen impedansundersøgelseleenfrekvens-screening tilrådes.

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