Hearing impairment screening

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Overview[edit | edit source]

The different recommendations for screening for hearing loss, at what age, and also describes the various methods for screening including whisper, hand rub, audiometer, different questionnaire and using smartphones.

Screening[edit | edit source]

Who should be screened

There are different recommendations for who should be screened for deafness, at what different age and presence of risk factors:^[1]

• The general rule is; screening should be carried for at-risk adults, little benefit exists on universal screening of adults or suggested interval screening in any group without being in danger for the hearing disorder. ^[2]

• There is insufficient evidence to screening among asymptomatic adults aged 50 years or older by U.S. Preventive Services Task Force ^[3]

• Medicare mandates screening as a part of the annual wellness examination for adults older than 65 years.

• Screen all adults once every decade until age 50 years and each 3 years afterward by the American Speech-Language-Hearing Association.

How to screen? ^[4]

• Studies showed that screening with simple tests on a clinic visit, like the whisper test, audio-scope, an otoscope, and audiometer, or a self-assessment questionnaire, results in easy screening with successful therapeutic or compensatory treatment.

• Single question: Do you believe you have hearing loss? (yes/no). Self-reported hearing difficulty changes by the degree of hearing loss ( mild/moderate, severe/profound) and sociodemographic characteristics and is typically difficult to select during a person with a light degree of deafness ^[7][8] There are multiple questionnaire assessment tests for instance Hearing Handicap Inventory for the Elderly Screening Version. It has a 10-item questionnaire with three options of “absent,” “present” and “sometimes,”

• The Weber and Rinne tests should not be used for general screening as they have little sensitivity for the detection of hearing loss. Elderly adults who know they have hearing impairment require audiometry for confirmation, while those who don't know about their hearing should be screened with the whispered-voice test as described in the table. Elderly adults who perceive the whispered voice require no further testing, while those unable to perceive the voice require audiometry for screening.^[9][10]
• The advancement of science has led to the development of mobile technology-based screening options, such as the use of different mobile phone apps (for example, uHear, Mimi) and smartphone or tablet-based portable audiometers that can be connected to conduct screening for hearing impairment. They generally require supra-aural headphones for monitoring.^[11]
• After deafness is diagnosed, the Weber and Rinne test can be conducted to differentiate whether it's a conductive, sensorineural, or mixed type hearing loss.
• All patients with hearing loss should be offered a referral to an audiologist or an otolaryngologist. Worrisome symptoms accompanying hearing loss like headache, weight loss, bleeding, etc. need urgent referral to an otolaryngologist for further investigations.

Genetic tests[edit | edit source]

• Genetic testing may be considered to be a significant tool for diagnosing hearing impairment in children. The genetic screening test is defined as the analysis of human DNA in order to detect heritable-related mutations in children as early as possible, to prevent cognitive impairment in kids.

References[edit | edit source]