Childhood Hearing Australasian Medical Professionals network: Consensus guidelines on investigation and clinical management of childhood hearing loss.

Abstract

Permanent hearing loss affects 1–3 per 1000 children in Australia1 ; this may be congenital or acquired, unilateral or bilateral, and ranges in severity from mild to profound. Hearing loss can be classified as sensorineural (SNHL), including auditory neuropathy, conductive and mixed (Table 1, Fig. 1). Australia has high-quality universal infant hearing screening, which facilitates early diagnosis and enables early intervention, hearing device fitting and timely planning for cochlear implantation if indicated.1,3 Although the National Framework for Neonatal Hearing Screening provides guidance on infant screening, and early intervention pathways are well established, aetiological investigation and medical management of newly diagnosed infants have varied. National guidelines are important to streamline management, ensure investigations are completed within relevant timeframes and reduce unnecessary stressors for families. Local and international evidence for the aetiological investigation of childhood hearing loss is heterogeneous and generally of low quality, with limited guidance on the structure or cost-effectiveness of investigations. A 2017 review recommended consensus guidelines to improve the management of hearing-impaired children,4 and both the British Association of Audiovestibular Physicians5–7 and the International Pediatric Otolaryngology Group8 have released guidelines. This position paper provides consensus recommendations for the aetiological investigation and medical management of children with SNHL, including auditory neuropathy, intended for general practitioners, paediatricians, otolaryngologists and genetic services in the Australian context.