The progression of impaired hearing for high tones during childhood

SUMMARY. The “abrupt” type of high‐tone loss is discussed from the standpoint, primarily, of remote or true causes of the lesion of the basal turn of the cochlea usually regarded as the immediate cause of the functional impairment Four cases are reported, in considerable detail, of children who while under observation either developed an “abrupt” type of high‐tone loss or had a marked degree of progression of an already existing impairment of this type. In all four instances, the impairments progressed gradually The cause of the impairments, had the last examinations of these children been their first, would have been regarded by most otologists as either an exposure to acoustic trauma of the blast type or a congenital cochlear lesion. The reported observations show that neither diagnosis would be correct for any of these four cases Other hypothetical, or even plausible, causes are discussed in the light of the evidence from the reported cases. All are ruled out of consideration, more or less completely, and the conclusion is reached that the remote or true cause of many instances of “abrupt” type high‐tone loss is as yet unknown, or unrecognized The suggestion is made that a follow‐up study of a large number of persons from childhood until they reach mid‐adult age would provide basic information about the most common type of impaired hearing that occurs in man, and that such a study would also furnish a better basis than now exists for clinical prognosis and advice