Paeds Vivas · investigations-procedures-and-technology
Audiology and hearing-test interpretation — branching viva
Branching viva on paediatric hearing-test interpretation: reading the pure-tone audiogram for degree and type, the Jerger tympanogram types and the 1000 Hz probe tone in infants, the OAE-to-ABR dissociation of auditory neuropathy, the two-stage newborn screen and the 1-3-6 milestones, and the late-onset risk in congenital cytomegalovirus.
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Study tools
Target exams
RACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Outpatient clinic: a 5-week-old infant referred on the newborn hearing screen sits in front of you with the parents, who are anxious. The examiner asks how you would interpret the diagnostic audiogram, the tympanogram, the OAE and the ABR together; the viva then branches to the 1000 Hz probe tone in a younger infant, to the OAE-present-ABR-absent pattern of auditory neuropathy, to the 1-3-6 milestones and loss to follow-up, and finally to the late-onset risk in congenital cytomegalovirus and the role of valganciclovir.
Opening question
This 5-week-old infant was referred on the newborn hearing screen. The diagnostic testing is now in front of you. Walk me through how you read a paediatric pure-tone audiogram, and tell me how you decide the degree and the type of hearing loss. [1]
References5ShowHide
- [1]Harlor AD Jr, Bower C Hearing assessment in infants and children: recommendations beyond neonatal screening Pediatrics, 2009.PMID 19786460
- [3]Gellrich D, Eder K, Echternach M, Gröger M, et al A Comparison of 226- and 1000-Hz Probe Tone Tympanometry With Myringotomy Findings in Infants Am J Audiol, 2024.PMID 39413047
- [11]Santarelli R, Scimemi P, Cama E, Domínguez-Ruiz M, et al Preservation of Distortion Product Otoacoustic Emissions in OTOF-Related Hearing Impairment Ear Hear, 2024.PMID 37677959
- [6]Buonsenso D, Pedrero-Tomé R, Raimondi F, Salomé S, et al Prognostic Factors of Late-onset Hearing Loss in Infants With Congenital Cytomegalovirus and Normal Audiologic Assessment at Birth Pediatr Infect Dis J, 2026.PMID 40838764
- [2]Awad R, Oropeza J, Uhler KM Meeting the Joint Committee on Infant Hearing Standards in a Large Metropolitan Children's Hospital: Barriers and Next Steps Am J Audiol, 2019.PMID 31084570