[The guideline 'Hearing Impairment' of the Dutch College of General Practitioners; a comment from the Netherlands Society of Otolaryngology and Cervico-Facial Surgery].

This guideline has been well thought out, and is a useful basis for the general practitioner to diagnose and manage hearing loss. However, it advises watchful waiting in children with otitis media, a questionable view. In evaluating simple diagnostic tools, the speech recognition is overvalued at the expense of audiometry and the tuning-fork test. Posttraumatic perforation of the eardrum, in combination with hearing loss is incorrectly presented as a self-limiting problem in the majority of cases.