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Douglas Shusterman; Steven D. Handler, MD; Roger R. Marsh, PhD; Larissa Bilaniuk, MD; Lawrence W. C. Tom, MD

Arch Otolaryngol Head Neck Surg. 1992;118(5):501-503.

Abstract
• A retrospective chart study was conducted to determine the diagnostic yield of temporal bone imaging for children with sensorineural hearing loss of unknown cause. Seventy consecutive cases, spanning 4.5 years, were identified and individual computed tomography films reviewed. Cases were analyzed with respect to patients' age, duration of hearing loss, sudden onset vs progressive loss, unilateral vs bilateral, and other symptoms. Of the 70 computed tomographic scans, nine showed temporal bone or other intracranial abnormalities. The majority of these findings were localized to structures in the posterior and middle cranial fossae. No eighth nerve tumors were identified. Congenital hearing loss and hearing loss secondary to viral infections are the most common cause of sensorineural hearing loss when discovered in early childhood and, often, have no radiographic abnormality. The decision to explore an ear for a presumed perilymph fistula is based almost exclusively on the history and physical examination, and not on the demonstration of any radiographic findings. For the children presenting with stable hearing impairment in the absence of other findings, computed tomgraphic scans were either negative or did not contribute to diagnosis. Since tumors of the eighth nerve are rare in children under 16 years of age (without neurofibromatosis), and radiologic studies have a low yield in identifying perilymph fistulas, the routine use of computed tomographic imaging in such children may be unjustified.

(Arch Otolaryngol Head Neck Surg. 1992;118:501-503)

Author Affiliations
From the Departments of Otolaryngology (Mr Shusterman and Drs Handler, Marsh, and Tom) and Radiology (Dr Bilaniuk), Children's Hospital of Philadelphia and the University of Pennsylvania School of Medicine.

Footnotes
Accepted for publication October 14, 1991.

Reprint requests to Children's Hospital of Philadelphia, Richard D. Wood Building, 1st Floor, 34th and Civic Center Blvd, Philadelphia, PA 19104 (Dr Handler).

Presented at the annual meeting of the Society of Ear, Nose, and Throat Advances in Children, Washington, DC, December 7,1990.

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