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Nichtorganische (funktionelle) Hörstörungen bei Kindern

Nonorganic (functional) hearing loss in children

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Zusammenfassung

Die nichtorganische (funktionelle) Hörstörung bezeichnet Hörauffälligkeiten ohne erkennbares organpathologisches Korrelat im auditorischen System. Das Krankheitsbild ist im Kindesalter nicht selten. Typisch ist eine Diskrepanz zwischen erhöhter Tonschwelle und wenig beeinträchtigter Sprachdiskrimination im Alltag. 85 Originalpublikationen (645 Fälle), 27 Übersichtsarbeiten und 4 Lehrbuchartikel wurden ausgewertet. Das mittlere Alter bei Diagnose lag bei 11,3 Jahren. Mädchen waren doppelt so oft betroffen wie Jungen. Familiäre und emotionale Probleme und Schulschwierigkeiten waren häufig. Bei organischen Hörstörungen traten funktionelle Verschlechterungen auf. Zur Diagnosesicherung sollte eine Hirnstammaudiometrie erfolgen. Differenzialdiagnosen sind auditive Verarbeitungs- und Wahrnehmungsstörungen, erhöhte Schwellen bei Entwicklungsverzögerungen und auditorische Neuropathien. Empfohlen werden eine biographische Anamnese, eine psychologische Untersuchung mit Intelligenzdiagnostik und ggf. eine kinderpsychiatrische/-psychotherapeutische Weiterbehandlung. Die Prognose scheint abhängig vom Ausmaß der belastenden Faktoren.

Abstract

Nonorganic (functional) hearing loss in children is characterized by hearing loss without a detectable corresponding pathology in the auditory system. It is not an uncommon disease in childhood. Typically, there is a discrepancy between elevated pure tone thresholds and normal speech discrimination in everyday life. We evaluated 85 original publications, 27 reviews and 4 textbook articles. Mean age at diagnosis was 11.3 years. Girls were affected twice as often as boys. Patient histories showed a high prevalence of emotional and school problems. Pre-existing organic hearing loss can be worsened by nonorganic causes. A brainstem audiometry should confirm the diagnosis. The differential diagnosis includes auditory processing disorder, elevated thresholds in mental retardation and auditory neuropathy. We recommend taking a personal history including biographical factors, a psychological assessment including intelligence testing and referral to a child psychiatrist. Prognosis seems to be dependent on the severity of the patient’s school and/or personal problems. Categorization following the Austen-Lynch model can be a valuable prognostic factor.

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Literatur

  1. Austen S, Lynch C (2004) Non-organic hearing loss redefined: understanding, categorizing and managing non-organic behaviour. Int J Audiol 43:449–457

    Article  PubMed  Google Scholar 

  2. Psarommatis I, Kontorinis G, Kontrogiannis A et al (2009) Pseudohypacusis: the most frequent etiology of sudden hearing loss in children. Eur Arch Otorhinolaryngol 266:1857–1861

    Article  PubMed  Google Scholar 

  3. Feldmann H (1989) Das Bild der psychogenen Hörstörung heute. Laryngorhinootologie 68:249–258

    Article  PubMed  CAS  Google Scholar 

  4. Boehme G (1984) Nichtorganische (funktionelle) Hörstörungen im Kindesalter. Laryngol Rhinol Otol 63:147–150

    Article  Google Scholar 

  5. Albrecht W (1918) Die Trennung der nicht-organischen von der organischen Hörstörung mit Hilfe des psychogalvanischen Reflexes. Eur Arch Otorhinolaryngol:1–19

    Google Scholar 

  6. Fröschels E (1944) Psychic deafness in children. Arch Neurol Psych 51:544–549

    Article  Google Scholar 

  7. Gelfand SA (2009) Nonorganic hearing loss. In: Gelfand SA (Hrsg) Essentials of Audiology. Thieme, New York, S 405–426

  8. Sohmer H, Baubergertell L, Feinmesser M et al (1977) Cochlear, brain-stem, and cortical evoked-responses in nonorganic hearing loss. Ann Otol Rhinol Laryngol 86:227–234

    PubMed  CAS  Google Scholar 

  9. Martin FN (2009) Nonorganic hearing loss. In: Katz J (Hrsg) Handbook of Clinical Audiology. Lippincott William & Wilkins, Baltimore, S 699–711

  10. Hiraumi H, Tsuji J, Kanemaru S et al (2007) Non-organic hearing loss. Acta Otolaryngol Suppl(557):3–7

    Article  Google Scholar 

  11. Goldstein R (1966) Pseudohypacusis. J Speech Hear Disord 31:341–352

    PubMed  CAS  Google Scholar 

  12. Camparelli P (1963) Simulated hearing losses in school children following identification audiometry. J Aud Res 3:91–108

    Google Scholar 

  13. Rintelmann W (1963) The detection and assessment of pseudohypoacusis among school-age children. J Speech Hear Disord 28:141

    PubMed  CAS  Google Scholar 

  14. Fiedler P (2009) Artifizielle (vorgetäuschte) Störungen. In: Schneider S, Margraf J (Hrsg) Lehrbuch der Verhaltenstherapie, Springer, Heidelberg, S 507–514

  15. Holenweg A, Kompis M (2010) Non-organic hearing loss: new and confirmed findings. Eur Arch Otorhinolaryngol 267:1213–1219

    Article  PubMed  Google Scholar 

  16. Saravanappa N, Mepham GA, Bowdler DA (2005) Diagnostic tools in pseudohypacusis in children. Int J Pediatr Otorhinolaryngol 69:1235–1238

    Article  PubMed  CAS  Google Scholar 

  17. Ban JH, Jin SM (2006) A clinical analysis of psychogenic sudden deafness. Otolaryngol Head Neck Surg 134:970–974

    Article  PubMed  Google Scholar 

  18. Doerfler LG (1951) Psychogenic deafness and its detection. Ann Otol Rhinol Laryngol 60:1045-1048 (disc 1060–1071)

    PubMed  CAS  Google Scholar 

  19. Yoshida M, Noguchi A, Uemura T (1989) Functional hearing loss in children. Int J Pediatr Otorhinolaryngol 17:287–295

    Article  PubMed  CAS  Google Scholar 

  20. Okitsu T, Taniguchi K, Hori F (1988) Nonorganic hearing loss in school screening tests. Audiology Japan 31:240–244

    Article  Google Scholar 

  21. Larr AL, Leamer BV (1957) Problems in the identification of non-organic hearing loss. Ann Otol Rhinol Laryngol 66:182–186

    PubMed  CAS  Google Scholar 

  22. Andaz C, Heyworth T, Rowe S (1995) Nonorganic hearing loss in children–a 2-year study. ORL J Otorhinolaryngol Relat Spec 57:33–35

    Article  PubMed  CAS  Google Scholar 

  23. Dixon RF, Newby HA (1959) Children with nonorganic hearing problems. AMA Arch Otolaryngol 70:619–623

    Article  PubMed  CAS  Google Scholar 

  24. Berger K (1965) Nonorganic hearing loss in children. Laryngoscope 75:447–457

    Article  PubMed  CAS  Google Scholar 

  25. Drake AF, Makielski K, McDonald-Bell C et al (1995) Two new otolaryngologic findings in child abuse. Arch Otolaryngol Head Neck Surg 121:1417–1420

    Article  PubMed  CAS  Google Scholar 

  26. Riedner ED, Efros PL (1995) Nonorganic hearing loss and child abuse: Beyond the sound booth. Br J Audiol 29:195–197

    Article  PubMed  CAS  Google Scholar 

  27. Veniar FA, Salston RS (1983) An approach to the treatment of pseudohypacusis in children. Am J Dis Child 137:34–36

    PubMed  CAS  Google Scholar 

  28. Lehrer ND, Hirschenfang S, Miller MH et al (1964) Nonorganic hearing problems in adolescents. Laryngoscope 74:64–69

    Article  PubMed  CAS  Google Scholar 

  29. Brockman SJ, Hoversten GH (1960) Pseudo neural hypacusis in children. Laryngoscope 70:825–839

    Article  PubMed  CAS  Google Scholar 

  30. Brooks DN, Geoghegan PM (1992) Non-organic hearing loss in young persons: Transient episode or indicator of deep-seated difficulty. Br J Audiol 26:347–350

    Article  PubMed  CAS  Google Scholar 

  31. Läßig AK, Keilmann A (2010) Funktionelle (psychogene) Hörstörung im Kindesalter – Kolibri oder unterschätztes Phänomen? In: Gross M, Am Zehnhoff-Dinnesen A (Hrsg) Aktuelle phoniatrisch-pädaudiologische Aspekte. S 45–48

  32. Radkowski D, Cleveland S, Friedman EM (1998) Childhood pseudohypacusis in patients with high risk for actual hearing loss. Laryngoscope 108:1534–1538

    Article  PubMed  CAS  Google Scholar 

  33. Aplin DY, Rowson VJ (1990) Psychological characteristics of children with functional hearing loss. Br J Audiol 24:77–87

    Article  PubMed  CAS  Google Scholar 

  34. Zorowka PG (1992) Psychogene Hörstörungen Im Kindes- und Jugendalter. HNO 40:386–391

    PubMed  CAS  Google Scholar 

  35. McCanna DL, DeLapa G (1981) A clinical study of twenty-seven children exhibiting functional hearing Loss. Lang Speech Hear Serv Sch 12:26–35

    Google Scholar 

  36. Zhao H, Dai CF, Chi FL et al (2008) Non-organic hearing loss in chinese teenagers. Auris Nasus Larynx 35:485-492

    Article  PubMed  Google Scholar 

  37. Tos M (1984) Epidemiology and natural history of secretory otitis. Am J Otol 5:459–462

    PubMed  CAS  Google Scholar 

  38. American Academy of Family Physicians, American Academy of Otolaryngology-Head and Neck Surgery, American Academy of Pediatrics Subcommittee on Otitis Media With Effusion (2004) Otitis media with effusion. Pediatrics 113:1412–1429

    Article  Google Scholar 

  39. Rintelmann WF, Schwan SA, Blakley BW (1991) Pseudohypacusis. Otolaryngol Clin North Am 24:381–390

    PubMed  CAS  Google Scholar 

  40. Kothe C, Fleischer S, Breitfuss A et al (2003) Diagnostik von psychogenen Hörstörungen im Kindesalter. HNO 51:915–920

    Article  PubMed  CAS  Google Scholar 

  41. Durmaz A, Karahatay S, Satar B et al (2009) Efficiency of stenger test in confirming profound, unilateral pseudohypacusis. J Laryngol Otol 123:840–844

    Article  PubMed  Google Scholar 

  42. Lehnhardt E (2009) Aggravation-Simulation-Psychogene Hörstörung. In: Lehnhardt E, Laszig R (Hrsg) Praxis der Audiometrie. Thieme, Stuttgart, S 194–202

  43. McCandless GA, Lentz WE (1968) Evoked response (EEG) audiometry in nonorganic hearing loss. Arch Otolaryngol -Head Neck Surg 87:123–128

    Google Scholar 

  44. Musiek FE, Bornstein SP, Rintelmann WF (1995) Transient evoked otoacoustic emissions and pseudohypacusis. J Am Acad Audiol 6:293–301

    PubMed  CAS  Google Scholar 

  45. Starr A, Picton TW, Sininger Y et al (1996) Auditory neuropathy. Brain 119(Pt 3):741–753

    Article  PubMed  Google Scholar 

  46. Balatsouras DG, Kaberos A, Korres S et al (2003) Detection of pseudohypacusis: a prospective, randomized study of the use of otoacoustic emissions. Ear Hear 24:518–827

    Article  PubMed  Google Scholar 

  47. Hosoi H, Tsuta Y, Murata K et al (1999) Suggestion audiometry for non-organic hearing loss (pseudohypoacusis) in children. Int J Pediatr Otorhinolaryngol 47:11–21

    Article  PubMed  CAS  Google Scholar 

  48. Bowdler DA, Rogers J (1989) The management of pseudohypacusis in school-age children. Clin Otolaryngol Allied Sci 14:211–215

    Article  PubMed  CAS  Google Scholar 

  49. Pracy JP, Walsh RM, Mepham GA et al (1996) Childhood Pseudohypacusis. Int J Pediatr Otorhinolaryngol 37:143–149

    Article  PubMed  CAS  Google Scholar 

  50. Zahnert T (2011) The differential diagnosis of hearing loss. Dtsch Arztebl Int 108(25):433–443

    PubMed  Google Scholar 

  51. Ptok M, Zehnhoff-Dinnesen A am, Nickisch A (2010) Auditive Verarbeitungs- und Wahrnehmungsstörungen - Definition: Leitlinien der Deutschen Gesellschaft für Phoniatrie und Pädaudiologie. HNO 58:617–620

    Article  PubMed  CAS  Google Scholar 

  52. Zenner HP (2010) Hearing–the gateway to speech and cognition. Dtsch Arztebl Int 108(25):425

    Google Scholar 

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  1. Klinik und Poliklinik für Phoniatrie und Pädaudiologie, Kardinal-von-Galen-Ring 10, 48149, Münster, Deutschland

    C.-M. Schmidt, A. am Zehnhoff-Dinnesen & D. Deuster

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  1. C.-M. Schmidt
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  2. A. am Zehnhoff-Dinnesen
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  3. D. Deuster
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Correspondence to C.-M. Schmidt.

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Schmidt, CM., am Zehnhoff-Dinnesen, A. & Deuster, D. Nichtorganische (funktionelle) Hörstörungen bei Kindern. HNO 61, 136–141 (2013). https://doi.org/10.1007/s00106-012-2504-3

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