Comparative study of pure-tone, impedance, and otoscopic hearing screening methods. A survey of native Indian children in British Columbia.

A survey of 1,109 native Indian children in five communities in British Columbia was conducted to determine incidence of middle ear pathologic features and to compare impedance and pure-tone audiometry as hearing screening methods. Survey teams included a public health nurse, two otologists, and two audiologists. On ear, nose, and throat (ENT) otoscopic examination, the incidence of middle ear disease requiring treatment was 12%. Disease was most prevalent in the preschool- and primary school-aged children. Pure-tone audiometry yielded 62% normal and 19% abnormal results. Nineteen percent of the children could not be tested by this method. Impedance audiometry yielded 54% normal and 38% abnormal results on the stringent criteria used to define the parameters of normality. Eight percent of the children could not be tested. Since there was a high incidence of middle ear pathologic features in the preschool group of children who could not be successfully evaluated by pure-tone audiometry, it is suggested that further investigation of impedance audiometry be undertaken in order to define parameters that will provide the most reliable referral criteria.