Round window membrane rupture and acquired sensorineural hearing loss in children.

The aetiology of acquired sensorineural hearing loss includes many conditions. The disparity between the number of children affected by the conditions which are supposed to cause hearing loss and the number of children who are actually deaf, has never been satisfactorily explained. Clinical features observed in children with surgically proven round window membrane rupture have been noted in all conventional aetiological groups. These features include otitis media, doubt about the hearing status in early life, disturbance of balance and other occasional neurological phenomena. Wide variation in the appearance of round window niche has been observed in children with secretory otitis and similar appearances have been observed in children with proven round window membrane rupture. The appearances may represent a reaction to perilymph. Round window membrane rupture is probably common and may prove to be a unifying factor for many cases of acquired sensorineural hearing loss. Occasional neurological phenomena may be related to it.