Hearing loss in a child

A hearing impairment in which the perception of sounds is preserved, but for some reason is difficult, is called deafness in medicine.

Hearing loss in children is a common problem, with 0.3% of children suffering from congenital forms of hearing loss, and 80% of young patients developing hearing problems in the first 3 years of life.

In children, hearing loss is linked to speech and intelligence, so it is essential to identify problems early and provide effective therapy.

Experts distinguish between congenital, hereditary and acquired hearing loss.

In case of pathology, the auditory ossicles, inner ear, auditory nerve, eardrums, parts of the auditory analyzer, and outer ear are affected.

The severity of the disease is assessed based on audiometric data:

• First degree - the child does not distinguish distant speech, sounds in extraneous noises, but hears conversation well from a distance of no more than 6 m, whispers - no more than 3 m.
• The second degree – only conversations from a distance of no more than 4 m are distinguished, whispers – no further than 1 m.
• Third degree – conversation can be heard from a distance of no more than 2m, whispering is not clear.
• The fourth degree - conversations are not distinguished.

Hearing problems can develop before or after speech begins.

ICD 10 code

In ICD 10, hearing loss in children is included under code H90.

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Causes of the child's hearing loss

Causes of hearing loss in children

There can be many reasons for hearing loss in a child. Almost 50% of congenital hearing pathologies are associated with hereditary diseases. In some children, hearing loss begins to form during intrauterine development, as a result of external negative influences: the expectant mother taking certain medications, smoking during pregnancy, etc.

In addition, hearing loss in newborns may be associated with birth hypoxia.

Hearing impairment in children may also appear later:

• as a complication after infectious diseases (flu, measles or mumps);
• as a result of head injuries;
• as a result of taking ototoxic medications.

Causes of hearing loss may include untreated otitis, adenoids, accumulations of sulfur secretions in the ears, as well as foreign objects that children place in the ear canals.

Sometimes hearing loss in a child is episodic or temporary. This condition is not associated with any pathology of the auditory organs: it is a kind of childish move, when the child hears only what he wants. This can be confirmed by conducting a special study - an audiogram.

A child's hearing may be impaired due to various reasons. Among the main ones, we can highlight the uncontrolled use of drugs that can have an ototoxic effect. Non-steroidal anti-inflammatory drugs (indomethacin) with prolonged use can provoke hearing loss in a child; with timely withdrawal of drugs of this group, hearing is gradually restored.

Antibiotics from the aminoglycoside group (streptomycin, tobromycin, etc.) affect the vestibular apparatus and can cause hearing loss (side effects include tinnitus).

Taking antineoplastic drugs or antidepressants can also affect a child's hearing. Such drugs, in case of urgent need, are prescribed in small doses, and the little patient must be under constant supervision of a doctor.

Another cause of hearing loss may be problems with the nervous system, neoplasms, brain injuries, foreign objects in the ear canal, the formation of earwax plugs, enlarged adenoids, and ENT diseases.

In most cases, after complete cure of the underlying disease, hearing is restored.

Hearing loss can occur due to the destruction of the sound-conducting villi due to excessively loud sounds (more than 90 decibels), the so-called acoustic trauma.

If 25% of the villi are damaged, hearing is significantly impaired; if more than 50% die, a person may completely lose hearing.

Acoustic trauma in childhood can be caused by the sound of a firecracker or a popper nearby, a loud bang next to the ear, etc.

Hearing loss can be caused by listening to loud music, especially with headphones, where the sound can reach 120 decibels and affect not only the hearing, but also the nervous system.

Vacuum headphones pose a particular danger to children's hearing, since they completely close the ear canal and transmit sound directly to the sensory apparatus. At the same time, the musical genre is of great importance, for example, rock music is dominated by low frequencies, and such music has a stronger effect on hearing, compared to classical music.

Experts note that hearing problems in childhood cannot be ignored, because the main thing is to identify the problem in a timely manner and begin treatment. Often, the child himself does not understand that his perception of sounds is impaired, so parents should pay attention to any signs (constant conversations in raised tones, frequent asking, etc.).

If you suspect hearing loss, you should consult an otolaryngologist.

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Hearing loss due to otitis in a child

Otitis is an inflammatory process in the ear. Specialists distinguish several types of the disease, which depend on the cause, type of inflammation (with fluid, pus), duration of the disease and the nature of the course, as well as on which part of the ear is affected (middle, outer, inner).

Hearing loss in children most often develops with acute otitis media, when fluid accumulates in the auditory canal, the eardrum becomes less mobile, and problems with sound perception arise.

The fluid that accumulates in the auditory canal often takes several weeks to resolve and hearing loss is considered a temporary complication following an illness; in rare cases, hearing problems can persist for more than three weeks.

Hearing loss in a child with adenoids

The nasopharyngeal tonsils, also known as adenoids, on the one hand do not allow viruses and pathogenic bacteria to enter the body, but on the other hand, they can become a source of chronic infection (due to the accumulation of pathogenic microorganisms in them).

The enlargement of the tonsils occurs mainly in childhood aged 3-7 years, it is during this period that the child's immunity "gets acquainted" with various bacteria and viruses that attack the body in huge quantities, and the adenoids are one of the types of barriers to pathogenic microorganisms.

At the peak of puberty (12-14 years), adenoids gradually decrease in size and by the age of 20, in most cases, there is practically nothing left of the organ.

An increase in the size of adenoids occurs during colds, during inflammatory processes, especially in children who are often ill.

The main sign of an enlarged nasopharyngeal tonsil is snoring, coughing, and runny nose.

In some children, adenoids serve to protect the body, while in others they become a source of constant infection, primarily in children with weak immune defenses, with untreated runny noses that lead to inflammation of the pharynx, trachea, bronchi, and those who are genetically predisposed.

In addition, dust, car exhaust, chemicals (detergents, powders, etc.) increase the risk of pathology.

Hearing loss in a child with adenoids is a common complication. The tonsils in the nasopharynx, when enlarged, can block the opening of the auditory tube and the air supply to the middle ear, which reduces the mobility of the eardrum.

Symptoms of the child's hearing loss

The main symptom of hearing loss is poor perception of sounds. Hearing loss can affect one or both ears at the same time.

As the pathology develops, children may complain of noise and congestion in the ears; in rare cases, nausea, dizziness, and loss of balance while walking occur.

The most common complication of infectious diseases is hearing loss in a child, after which concern should be caused by a lack of reaction to loud sounds, complaints of any discomfort in the ears.

As a rule, small children react emotionally to loud sounds, turning their heads in the direction of the noise; if the child’s reaction is suspicious, it is necessary to urgently consult a doctor.

At an older age, hearing problems are associated with poor speech; the child does not speak and tries to explain everything with gestures.

Parents should also be alerted by the child’s habit of asking everything again, as this can also be caused by a hearing problem.

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First signs

Hearing loss is quite difficult to notice in a child, especially in the first year of life.

At 2-3 weeks, a child without hearing impairment usually blinks or flinches at loud sounds, freezes when hearing the voices of others, begins to turn his head in the direction of the noise, and reacts to his mother’s voice.

From 1.5 to 6 months, the reaction to noise can be manifested by crying or wide-open eyes.

At 2-4 months, the child already begins to reproduce some sounds (cooing, babbling, etc.).

At 8-10 months, the baby begins to pronounce the first sounds that he hears from others, and at one year, he begins to say the first words.

Moreover, regardless of age, a child can react to loud noise or screams in his sleep.

With hearing loss, there is a delay in development, for example, speech delay. A small child does not respond to a voice, rattles (does not turn his head, does not flinch at a sharp sound, does not try to babble, etc.).

Hearing loss in an older child may manifest itself in constant asking questions, hearing only loud speech, and not responding to whispers or quiet speech.

If you suspect hearing loss, you should immediately consult a doctor to start treatment in a timely manner (it is worth noting that children may consciously not respond to their parents' words or ask again, but in any case, you should not neglect a doctor's consultation).

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Forms

Experts distinguish three types of hearing loss, which depend on the area of damage:

• sensorineural (branches of the auditory nerve)
• sensory (hairs responsible for the perception of sounds)
• central hearing loss (auditory centers).

The disease also has different degrees of severity: mild (ability to perceive sounds up to 6 m is preserved), moderate (speech perception up to 4 m), severe (auditory sounds up to 1 m).

Hearing loss in a child can be acute, subacute or chronic.

In acute cases, the disease develops over several days or hours, and the lesions are usually reversible.

In subacute cases, the disease develops over 1-3 months.

In a chronic process, the disease develops over more than three months.

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Complications and consequences

The consequences of hearing loss depend on the severity and characteristics of the child's body.

Hearing impairment can be mixed, mild, moderate or severe, the disease can develop suddenly or gradually, be stable, paroxysmal or progress rapidly, the child may not hear the entire spectrum of sounds or only a certain range of sounds.

Mental capacity, general health (including concomitant diseases), age at onset of the disease, timely diagnosis and adequate therapy may also play a role.

In most cases, hearing is preserved to some extent; only in 6% of cases is complete bilateral hearing loss observed, significantly reducing the quality of life.

Hearing loss in a child at an early age can affect speech development, emotional and social development, and learning ability.

Sometimes there are erroneous diagnoses, since children with this pathology can react to surrounding sounds, learn to speak, but some tasks are beyond their capabilities.

Even mild hearing loss can impact development and learning ability, especially in school-aged children.

Such children perceive information worse in the presence of extraneous noise and poor acoustics.

If your child is inattentive in school, has problems with speech, or has poor behavior or studies, you should check your child for possible hearing problems.

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Complications

With hearing loss, various complications are possible, the most severe of which can be complete deafness, in which the child’s quality of life is significantly reduced.

Deafness occurs if the disease proceeds without qualified assistance, in which case the child’s hearing loss only becomes more severe over time until the hearing disappears completely.

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Diagnostics of the child's hearing loss

Diagnosis of hearing loss in children has some features that are related to age. To confirm the diagnosis, specialists analyze the child's health (what he or she has suffered from in the past, chronic diseases, general health, etc.). In addition, the specialist finds out the health of family members to exclude a hereditary factor.

Hearing loss in a child is determined using the Weber test, tuning fork test, audiometry, and impedancemetry.

The Weber test is designed to detect unilateral or bilateral hearing loss.

A tuning fork test is necessary to establish the conductivity of hearing, impedancemetry is necessary to identify the causes of pathology and the location of damage (auditory centers, hairs, etc.), audiometry is necessary to determine auditory sensitivity and the degree of hearing loss.

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Tests

In case of hearing loss, the doctor prescribes tests to determine blood clotting, liver function, evaluates the work of the cardiovascular and endocrine systems, prescribes urine and blood tests for sugar and hormone levels.

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Instrumental diagnostics

Hearing loss in a child is diagnosed using audiological and acoustic data. Tuning fork tests and recording of a tonal threshold audiogram are mandatory.

The set of tuning forks includes the Rinne experiment (for comparing air and bone conduction), the Gelle experiment (reveals a violation of the mobility of the stapes), the Weber experiment (reveals the lateralization of sound), and the Schwabach experiment (reveals damage to the sound-perceiving apparatus).

All data obtained during the study are recorded in a special hearing passport.

Audiometry at a frequency of over 8 thousand Hz can be used as an additional diagnostic tool. The study is conducted by an audiologist using an audiometer (less often using tuning forks).

This diagnostics allows to study both air and bone conduction. The results are recorded on an audiogram, based on which the ENT specialist makes a final diagnosis.

Impedancemetry is prescribed to detect ruptures of the auditory ossicular chain, disorders of the auditory tube, and microperforations of the tympanic cavity.

This diagnostic method includes tympanometry and recording of the acoustic reflex (carried out at a frequency of up to 4000 Hz, on the basis of which the doctor evaluates speech perception in young children). Diagnostics are carried out on an outpatient basis, without additional medications.

Differential diagnosis

In differential diagnostics, special attention is paid to ultrasound examination - damage to the conduction pathways and the inner ear apparatus is observed with impaired perception of ultrasound, damage to the sound-conducting canal of the middle ear - with normal perception of ultrasound.

Non-purulent ear diseases are given special attention. Hearing loss in a child can be caused by chronic tubootitis, Meniere's disease, adhesive otitis, otosclerosis, sensorineural hearing loss.

Treatment of the child's hearing loss

Hearing loss in a child can develop quickly or gradually, but in any case, at the first suspicion, you should immediately consult a doctor so as not to waste time and begin treatment.

The standard treatment regimen includes diuretics, antispasmodics, anti-inflammatory drugs, sedatives, anticoagulants, and detoxifying agents.

Treatment is usually carried out in the otolaryngology department, under the supervision of a specialist. Drug treatment in subacute or chronic forms is ineffective, but in other forms, drugs significantly improve the patient's condition and allow hearing to be restored.

Nootropic (piracetam, cerebrolysin, vinpocetine) drugs and agents for improving microcirculation and rheological properties of blood (pentoxifylline) are prescribed in a course of 2-3 weeks to six months (2 tablets 2-3 times a day), drugs can be prescribed in the form of droppers or injections (intravenously or intramuscularly), some drugs are intended for administration directly into the inner ear.

If the patient is bothered by dizziness, unsteadiness when walking, drugs are prescribed that affect the area responsible for body position - betaserk, betahistine (0.5 - 1 tablet 3 times a day).

All patients with hearing loss are prone to allergic reactions, so antihistamines are prescribed without fail.

Antibacterial therapy is prescribed if the disease is caused by an infection. Hormonal therapy is used for connective tissue lesions.

In addition to drug therapy, physiotherapy is prescribed to improve the therapeutic effect, which improves the flow of drugs to the affected area, improves blood circulation in the inner ear. Hyperbaric oxygenation (use of oxygen under high pressure in special pressure chambers) is often prescribed for these purposes.

Alternative treatment methods include cochlear implantation, a special implant that transmits sound signals and stimulates the auditory nerve.

In case of acute hearing loss, complex therapy allows for almost complete (sometimes completely) restoration of hearing.

In chronic and subacute forms, hearing restoration occurs partially; sometimes the doctor recommends using hearing aids.

Medicines

In case of hearing loss, the doctor prescribes medications taking into account the severity of the disease and the cause that caused the pathological process.

If a child's hearing loss is related to blood vessels, medications are used to improve cerebral circulation and blood supply to the inner ear.

Such drugs include nicotinic acid (0.5 tablets 3 times a day), caviton (0.5 tablets 3 times a day), papaverine (5-20 mg 3-4 times a day, depending on age), euphyllin (7-10 mg per day), dibazol (1-5 mg per day).

If hearing loss is associated with an infection, non-toxic antibiotics are prescribed; in case of intoxication, metabolic, dehydration and detoxifying agents are prescribed.

Folk remedies

You can try to treat hearing loss in a child using folk methods, but it is better to start treatment after consulting a doctor; perhaps, to enhance the effect, the doctor will recommend supplementing drug therapy with folk remedies.

Mix propolis alcohol tincture (1 teaspoon) with olive oil (4 teaspoons), soak gauze pads with the resulting mixture.

Carefully insert into the ear canal, remove after 36 hours, repeat no earlier than after 24 hours (a total of 12 procedures will be required).

Onions help cleanse the ear canals of wax and various impurities.

To prepare onion drops, you will need a large onion and dill seeds. Make a large hole in the onion, add 1 teaspoon of dill and bake until brown. Then squeeze well through cheesecloth and drip warm juice 9 drops into the affected ear 3-4 times a day.

Drops can be stored in a cool place, warming up before use. Usually after the procedure, dirt and wax start to flow out of the ears, then hearing is gradually restored.

The course of treatment is 1 month.

Among folk methods, copper is very popular, as it helps with various diseases, including hearing loss.

For treatment you will need two sheets of copper (approximately 3mm thick), red and yellow.

From the sheets you need to make two small circles (with a radius of about 1 cm). Apply one circle to the tragus, the second to the bone behind the ear, so that they are opposite each other, fix the copper with a plaster. After 12 hours (you can do the procedure at night) remove the circles and wash the ears with soap.

The mugs should also be washed and dried.

The course of treatment is until hearing is completely restored.

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Herbal treatment

Hearing loss in children can also be treated with herbs. Bay leaves show good effectiveness in cases of hearing loss.

There are different recipes, among which the following can be highlighted:

• Pour 200 ml of boiling water over 2 tbsp of chopped bay leaf, leave for about 2 hours, strain.

Instill the resulting tincture 1-2 drops daily for two weeks.

• Grind several bay leaves in a coffee grinder, add 100 ml of vodka and 1 tbsp of vinegar (9%), leave in a dark place for 14 days.

Instill 2-3 drops of the tincture 3 times a day until your hearing is restored (this recipe helps with hearing loss after an illness).

• Pour 200 ml of sunflower oil over 10-12 bay leaves and leave for a week.

Rub the resulting solution onto your temples 3 times a day. This solution will also help eliminate tinnitus - instill 2-3 drops of the infusion 2 times a day.

Melissa herb will help get rid of the noise - pour 2 tablespoons with 6 tablespoons of alcohol, leave for a week, strain and use as drops - 3 drops 2 times a day.

Drinking a decoction of calamus roots will help improve your hearing: 200 ml of water and 1 tbsp of roots.

Boil for half an hour, add boiled water to make 200 ml.

Drink 15 ml before meals 3 times a day.

Lingonberry leaves help cure hearing loss: pour 200 ml of boiling water over a few leaves, leave for 1 hour, drink 100 ml before meals in the morning and evening.

Homeopathy

Homeopathic treatment shows good results in any inflammatory processes. The main goal of such treatment is to minimize the use of antibiotics and increase the body's own defenses.

This treatment can be used either alone or in combination with physiotherapy procedures.

Hearing loss in a child may occur with otitis, the treatment of which with homeopathy lasts about 2 weeks; in chronic processes, the course of treatment increases to 2-3 months; in some cases, a repeat course is recommended after 3 months.

Classical homeopathy involves an individual approach to each patient, and this treatment is aimed not only at a specific disease, but at strengthening the entire body.

With the help of homeopathic remedies, the specialist stimulates the immune system. Each drug is selected taking into account the severity and course of the disease, individual characteristics of the body, and the drugs are taken exclusively as prescribed by a doctor.

Surgical treatment

Surgery is usually prescribed for conductive hearing loss.

Treatment in this case depends on the cause of the pathology. If the integrity of the eardrum is compromised, myringoplasty is prescribed, during which the surgeon replaces the eardrum with an artificial analogue.

If a child's hearing loss is caused by a strong change in atmospheric pressure (for example, during takeoff or landing of an airplane), Politzer insufflation is prescribed.

If the cause of hearing loss is purulent otitis and the pathological process has affected the auditory ossicles in the middle ear, an operation is prescribed in which the damaged ossicles are replaced with artificial ones.

If the auditory nerve is not affected, the doctor may consider performing a cochlear implant, which can significantly improve hearing.

This operation involves the implantation of a special device that will act as the hair cells of the inner ear.

Prevention

Prevention of hearing loss should begin with a pregnant woman, who needs to take good care of her health during this period and avoid contact with infectious patients (in particular, rubella).

When treating a child, before giving him any medication, you need to study the instructions carefully and make sure that the medication does not have an ototoxic effect.

It is worth noting that hearing loss in a child is often a complication of a disease, so it is necessary to promptly and completely treat viral and infectious diseases, and provide the patient with maximum rest.

If a child has suffered from hearing loss in the past, the risk of relapse increases with exhaustion of the body, infectious diseases, and stress.

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Forecast

The prognosis is favorable with timely detection of pathology and adequate therapy. In this case, hearing loss in a child will not lead to developmental delays, speech and psychological deviations.

Hearing loss in a child is a severe pathological process that can affect the overall development of the child and lead to complete hearing loss. According to statistics, one child out of every thousand newborns has impaired hearing, and several of these thousand children may lose their hearing during their growth for one reason or another (trauma, infection, etc.).

A child's health largely depends on the parents, and hearing is no exception in this case. Only parents can notice the first signs of hearing loss in their child and consult a doctor.

If time is lost, the treatment will take longer and hearing will not be fully restored.

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