[Psychogenic hearing impairment in differential diagnosis of sudden hearing loss].

INTRODUCTION: Acute hearing impairment or deafhess may manifest as unilateral or bilateral. The etiopathogenetic substrate may be organic, functional and of unknown origin, the so-called idiopathic. The functional causes of impaired hearing and deafness also include psychogenic factors, where the essential dysfunction exists between the conscious simulation of hearing impairment and deafness for benefits versus psychogenic hearing impairment in conversion disorders where physical symptoms result as a symbolic expression of long-term psychological problems or conflicts. Acute hearing impairment, pseudohypacusis, as a symptom of conversion disorder, where hearing impairment is without evidence of organic cause, is a rare pseudosensory form of this disease. Numerous literature data indicate that these disorders are most common among children, whereas in adults only individual cases are reported. In otorhinolaryngological practice, other symptoms of conversion disorders are much more common (psychogenic aphonia and dysphonia, globus pharyngeus, sensation disorder in the head and neck region).

CASE REPORT: The paper includes a detailed presentation of the diagnostic procedure, clinical course, differential diagnostic dilemmas and therapeutic procedure in cases of acute bilateral psychogenic hearing impairment in adolescents.

CONCLUSION: Acute hearing impairment caused by organic substrate is irreversible in most cases, whereas in psychogenic hearing impairment the prognosis is excellent, particularly among children and adolescents. Identification of the etiologic factors of reversible hearing loss, including psychogenic ones, by the otorhinolaryngologist is of utmost importance in order to provide early differential diagnosis and timely inclusion of a psychiatrist and a clinical psychologist into the diagnostic-therapeutic.