ABSTRACT
Hearing impairment is either sensorineural or conductive. As parents may not recognise mild or high-frequency hearing impairment and as hearing impairment has a major impact on the child's language and communication, screening testing during the neonatal period is strongly advocated, and usually performed by the third day of life. Infection of the middle ear is usually caused by a viral infection. Any ear discharge has to be differentiated from earwax and water that entered the ear canal during showering or swimming. Bloody discharge may follow a direct trauma; a foreign object in the ear canal and, rarely, a tumour should be excluded. Congenital deafness due to congenital infection or genetically determined impairment may escape neonatal screening testing and deteriorate during the first 2 years of life. A child with unilateral progressive deafness, vertigo and tinnitus should be suspected as having acoustic neuroma.
