Hearing loss in the child

Hearing impairment, in which perception of sounds remains, but for some reason is difficult, in medicine is called deafness.

Hearing loss in a child is a common problem, with 0.3% of children suffering from congenital deafness, and 80% of small patients are hearing problems in the first 3 years of life.

In children, hearing loss is intertwined with speech and intelligence, so it is extremely important to identify problems at an early stage and to conduct effective therapy.

Specialists distinguish congenital, hereditary and acquired hearing loss.

In pathology, auditory ossicles, inner ear, auditory nerve, tympanic membranes, auditory analyzer sections, external ear are affected.

The severity of the disease is estimated by audiometric data:

• First degree - the child does not distinguish between distant speech, sounds with extraneous noise, but he can hear the conversation from a distance of not more than 6 m, whispering - no further than 3 m.
• The second degree - only talk from a distance of not more than 4 m, whispers - no more than 1 m.
• Third degree - the conversation differs from a distance of not more than 2 m, a whisper is not distinct.
• Fourth degree - there are no different conversations.

Hearing problems can develop before or after the appearance of speech.

Code for micro-10

In the ICD 10, the child's hearing loss is included under the code H90.

[1], [2]

Causes of the hearing loss in a child

The causes of hearing loss in a child

The reasons for hearing loss in a child can be many. Practically 50% of congenital pathologies of hearing are connected with hereditary diseases. In some children, hearing loss begins to form during intrauterine development, as a result of external negative effects: the mother's taking certain medications, smoking during pregnancy, etc.

In addition, hearing loss in newborns can be associated with ancestral hypoxia.

Violation of auditory function in children may appear later:

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

The causes of hearing loss can be untreated otitis, adenoids, accumulation of sulfur secretions in the ears, as well as foreign objects that children are placed in the ear canals.

Sometimes the hearing loss in a child is episodic, or temporary. Such a 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 compromised due to various reasons. Among the main ones, one can single out uncontrolled use of drugs that can have an ototoxic effect. Non-steroidal anti-inflammatory (indomethacin) for prolonged use can trigger a decrease in hearing in a child, with the timely withdrawal of drugs in this group, hearing is gradually restored.

Antibiotics from the group of aminoglycosides (streptomycin, tobromycin, etc.) affect the vestibular apparatus and can provoke hearing loss (tinnitus among side effects).

Taking antiplastic drugs or antidepressants can also affect the hearing of the child. Such drugs, in case of acute necessity, are prescribed in small dosages, while a small patient must be under constant medical supervision.

Another cause of hearing loss may be disorders in the work of the nervous system, neoplasms, brain traumas, foreign objects in the ear canal, the formation of sulfur plugs, enlarged adenoids, ENT diseases.

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

Hearing impairment can occur due to the destruction of villi that conduct sound, due to too loud sounds (more than 90 decibels), the so-called acoustic trauma.

If 25% of the villi are affected, hearing is severely impaired, if more than 50% die - a person can completely lose his hearing.

To acoustic trauma in childhood can result in the sound of firecrackers or crackers near, strong cotton next to the ear, etc.

Hearing impairment can trigger hearing of loud music, especially in headphones, in which sound can reach 120 decibels and affect not only the hearing, but also the nervous system.

A special danger for children's hearing is the vacuum headphones, since they completely cover the ear canal and spread the sound directly to the sensory device. In this case, the musical genre is important, for example, low frequencies prevail in rock, and this music affects the hearing more strongly, in comparison with the classical one.

Specialists note that hearing problems in childhood can not be ignored, because the main thing is to timely identify the problem and start treatment. Often, the child himself does not understand that his perception of sounds is disturbed, so parents should pay attention to any signs (constant conversations on high tones, frequent re-asking, etc.).

If you suspect a decrease in hearing, you should consult an otorhinolaryngologist.

[3],

Hearing loss in otitis in children

Otitis is an inflammatory process in the ear. Specialists identify several types of diseases that depend on the cause, the type of inflammation (with fluid, pus), the duration of the disease and the nature of the flow, and also on which ear region is affected (middle, outer, inner).

Hearing loss in a child often develops with acute otitis media, when liquid accumulates in the auditory department, the eardrum becomes less mobile and problems with perception of sounds appear.

The fluid that accumulates in the auditory department often dissipates for several weeks and hearing loss is considered a temporary complication after the illness, in rare cases hearing problems can occur for more than three weeks.

Hearing loss in a child with adenoids

Nasopharyngeal tonsils, they are adenoids, on the one hand do not pass viruses and pathogenic bacteria into the body, and on the other can become a source of chronic infection (due to the accumulation of pathogens in them).

The increase in tonsils occurs mainly in childhood 3-7 years, it is during this period that the child's immunity "get to know" with a variety of bacteria and viruses that attack the body in huge quantities, and 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, from the body, there is practically nothing left.

The increase in adenoids in size occurs during the period of catarrhal diseases, in inflammatory processes, especially in frequently ill children.

The main sign of an increase in nasopharyngeal tonsils is snoring, coughing, nose sniffing.

In some children, adenoids serve to protect the body, others become a source of constant infection, in the first place, these are children with weak immune defenses, with an undersized rhinitis that leads to inflammation of the pharynx, trachea, and bronchi, genetically predisposed.

In addition, the risk of pathology is increased by dust, car exhausts, chemical agents (detergents, powders, etc.).

Hearing loss in a child with adenoids is a common complication. Tonsils in the nasopharynx, when enlarged, can block the mouth of the auditory tube and air in the middle ear, which reduces the mobility of the tympanic membrane.

Symptoms of the hearing loss in a child

The main symptom of hearing loss is poor perception of sounds. Hearing loss can strike one or both of the two ears.

With the development of pathology, children can complain of noise and stuffiness in the ears, in rare cases there is nausea, dizziness, loss of balance during walking.

The most common complication of infectious diseases is hearing loss in a child, after which anxiety should cause a lack of response to loud noises, complaints of any discomfort in the ears.

As a rule, with loud sounds, young children react emotionally, turn their heads towards noise, if the child's reaction causes suspicion, it is necessary to consult a doctor immediately.

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

Parents should also be alert to the child's habit of asking everything again, since this too can be caused by a hearing problem.

[4], [5]

First signs

Deafness is hard to notice in a child, especially the first year of life.

In 2-3 weeks the child without hearing loss, usually blinks or flinches at a loud sound, freezes, hearing voices of associates, starts to turn a head aside noise, reacts to a mother's voice.

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

In 2-4 months the child is already beginning to reproduce some sounds (walking, babbling, etc.).

In 8 - 10 months, the baby begins to pronounce the first sounds that hears from others, and a year - begins to speak the first words.

However, regardless of age, a child in a dream can react to loud noises or screams.

With hearing loss there is a lag in development, for example, speech delay. A small child does not react 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 can be manifested by constant recollections, hears only a loud speech, does not react to a whisper or a quiet speech.

With any suspicion of hearing loss, you should immediately consult a doctor to start treatment promptly (it should be noted that children can not consciously react to the words of their parents or ask again, but the doctor's advice in any case should not be neglected).

[6]

Forms

Specialists distinguish three types of deafness, which depend on the site of the lesion:

• sensorineural (branches of the auditory nerve)
• Sensory (hairs responsible for the perception of sounds)
• deafness of the central genesis (auditory centers).

Also the disease has different degrees of severity: light (the ability to perceive sounds up to 6 m is retained), average (speech perception up to 4 m), heavy (audibility of sounds up to 1 m).

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

In acute disease, the disease develops in a few days or hours, lesions usually have a reversible character.

With subacute - the disease develops 1-3 months.

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

[7],

Complications and consequences

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

Hearing impairment can be mixed, weak, moderate or severe, the disease can develop suddenly or gradually, flow steadily, paroxysmally or rapidly progress, the child may not hear all or only a certain range of sounds.

A mental capacity, general health (including concomitant diseases), the age at which the disease has developed, a timely diagnosis and adequate therapy can play a role.

In most cases, hearing is to some extent preserved, only in 6% of cases there is complete bilateral deafness, which significantly reduces the quality of life.

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

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

Even a slight decrease in hearing can affect development and its ability to learn, especially among schoolchildren.

Such children are less aware of information in the presence of extraneous noise, poor acoustics.

If the child is inattentive for school lessons, problems with speech, bad behavior or studies, the child should be checked for possible hearing problems.

[8], [9], [10], [11], [12]

Complications

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

Deafness occurs if the disease occurs without qualified care, in this case, the child's hearing loss in the course of time only flows into a heavier form until the hearing completely disappears.

[13], [14], [15], [16]

Diagnostics of the hearing loss in a child

Diagnosis of hearing loss in children has some features that are associated with age. To confirm the diagnosis, experts analyze the state of health of the child (what has been ill in the past, chronic diseases, general health, etc.). In addition, the specialist finds out the health status of family members in order to exclude a hereditary factor.

Hearing loss in a child is determined using a Weber test, a tuning fork, audiometry, impedance measurement.

The Weber test is aimed at identifying one-sided or bilateral hearing loss.

A tuning test is necessary to establish conduction of hearing, impedance measurement - to identify the causes of pathology and the site of damage (auditory centers, hairs, etc.), audiometry - to determine auditory sensitivity and the degree of hearing loss.

[17], [18], [19], [20], [21]

Analyzes

With the deafness of the doctor appoints tests for the definition of blood clotting, liver function, assesses the work of cardiovascular, endocrine systems, appoints an analysis of urine, blood on the level of sugar and hormones.

[22], [23], [24], [25]

Instrumental diagnostics

Hearing loss in a child is diagnosed using audiologic and acoustic data. Mandatory ordering of tuning forks and recording of a tone threshold audiogram are mandatory.

The set of tuning forks includes the Rinne experiment (for comparison of air and bone conduction), the Gellee experience (reveals a disturbance in the mobility of the stirrup), Weber's experience (reveals lateralization of sound), the Schwabach experience (reveals the damage to the sound receiving apparatus).

All data obtained during the study are recorded in a special audit certificate.

As an additional diagnostic tool can be used audiometry at a frequency of more than 8 thousand Hz. The study is conducted by the audiologist using an audiometer (less often with the help of tuning forks).

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

Impedansometry is assigned to detect a rupture of the auditory ossicles, damage to the auditory tube, and microperforations of the tympanic cavity.

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

Differential diagnosis

In differential diagnosis, special attention is paid to ultrasound investigation - the damage of the conducting paths and the apparatus of the inner ear is observed when the perception of ultrasound is disturbed, the sound channel of the middle ear is damaged - under normal perception of ultrasound.

Pulmonary diseases of the ear are given special attention. Hearing loss in a child can cause chronic tuboitis, Meniere's disease, adhesive otitis, otosclerosis, sensorineural hearing loss.

Treatment of the hearing loss in a child

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

The standard treatment regimen includes diuretics, antispasmodics, anti-inflammatory, sedative, anticoagulants, detoxification agents.

Treatment is usually conducted in the otolaryngology unit, under the supervision of a specialist. Drug treatment in subacute or chronic form is ineffective, but in other forms, medications significantly improve the patient's condition and help restore hearing.

Nootropics (piracetam, cerebrolysin, vinpocytin) preparations and agents for improving microcirculation and rheological properties of blood (pentoxifylline) are prescribed by a course of 2-3 weeks to 6 months (2 tablets 2-3 times a day), drugs may be given in the form of droppers or injections intravenously or intramuscularly), some of the drugs are intended to be injected directly into the region of the inner ear.

If the patient is worried about dizziness, unstable walking, drugs are prescribed that affect the area responsible for the body position - betaserc, betagistin (0.5-1 tablets 3 times a day).

All patients with hearing loss are prone to allergic reactions, so mandatory mandatory antihistamines are prescribed.

Antibiotic therapy is prescribed if the disease is caused by an infection. When lesions connective tissue use hormonal therapy.

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

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

In acute hearing loss complex therapy allows almost completely (sometimes in full) to restore hearing.

In chronic and subacute form, hearing restoration occurs in part, sometimes the doctor recommends the use of hearing aids.

Medications

With the deafness of the doctor prescribes medications taking into account the severity of the disease and the cause that caused the pathological process.

If the hearing loss in a child is associated with blood vessels, funds are used to improve cerebral circulation and blood supply in 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 the age), euphyllin ( 7-10 mg per day), dibazol (1-5 mg per day).

If the hearing loss is associated with the infection, non-toxic antibiotics are prescribed, with intoxications - metabolic, dehydrating and detoxifying agents.

Alternative treatment

Hearing loss in a child can be tried by alternative methods, but it is better to start treatment after consulting a doctor, perhaps to enhance the effect the doctor will recommend adding medication therapy with alternative medicine.

Mix the alcoholic tincture of propolis (1 tea) with olive oil (4 tsp), soak gauze tampons with the mixture obtained.

Gently insert into the ear canal, after 36 hours, remove, repeat not earlier than 24 hours (in all, 12 procedures will be required).

Onion helps to clean ear holes from sulfur and various contaminants.

To prepare onions, a large bulb and dill seeds are required. In a bow to make a large hole, put 1 h. Dill and bake until brown. Then squeeze well through gauze and drip warm juice 9 drops into the affected ear 3-4 times a day.

Drops can be stored in a cool place, preheating before use. Usually, after the procedure, dirt begins to flow from the ears with sulfur, then the hearing is gradually restored.

The course of treatment is 1 month.

Among the alternative methods, copper is very popular, which helps with various diseases, including hearing loss.

For treatment, two copper sheets (about 3mm thick), red and yellow, are required.

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

Mugs are also washed and dried.

The course of treatment - until the full restoration of hearing.

[26], [27], [28], [29], [30], [31]

Herbal Treatment

Hearing loss in the child can also be treated with herbs. Good efficiency with deafness shows bay leaves.

There are different recipes, among which are the following:

• 2 tablespoons crushed bay leaf pour 200ml of boiling water, insist about 2 hours, strain.

The received tincture to instill on 1-2 drops within two weeks daily.

• in a coffee grinder, grind a few leaves of laurel leaves, add 100ml of vodka and 1 tbsp. Vinegar (9%), insist in a dark place for 14 days.

Brew infusion 2-3 drops a day 3 times a day until hearing is restored (this recipe helps with hearing loss after the disease).

• 10-12 leaves of laurel pour 200ml of sunflower oil, insist for a week.

Obtained means to rub whiskey 3 times a day. Also this remedy will help to remove noise in the ears - bury infusion 2-3 drops 2 times a day.

Get rid of the noise will help grass melissa - 2 tablespoons. Pour 6 tablespoons. Alcohol, insist for a week, strain and use as drops - 3k. 2 times a day.

Improve the hearing will help the use of decoction from the roots of aira: 200 ml of water and 1 t.l. Roots.

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

Drink before meals 3 times a day for 15ml.

To cure deafness help leaves cranberries - a few leaves pour 200ml boiling water, insist 1 hour, drink 100 ml before meals in the morning and evening.

Homeopathy

Homeopathic treatment shows a good effect in any inflammatory process. The main goal of such treatment is to minimize the intake of antibiotics and increase the body's own defenses.

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

Hearing loss in a child can occur with otitis, whose treatment with homeopathy lasts about 2 weeks, in chronic cases, the course of treatment is increased to 2-3 months, in some cases it is recommended to repeat the course in 3 months.

Classical homeopathy assumes an individual approach to each patient, and this treatment is directed not only to a specific disease, but to 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, the individual characteristics of the body, while the drugs are taken solely by the doctor's prescription.

Operative treatment

The operation is usually prescribed with a deafness of conductive type.

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

If a child's hearing loss is caused by a strong drop in atmospheric pressure (for example, during take-off or landing of an airplane) purging by Politzer is appointed.

If the cause of the deafness is purulent otitis and the pathological process touches the auditory ossicles in the middle ear, an operation is appointed in which the damaged bones are replaced by artificial ones.

If the auditory nerve is not affected, the physician may find it advisable to perform cochlear implantation, 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 deafness should begin with a pregnant woman who needs to take care of her health during this period, avoid contact with infectious patients (in particular, rubella).

During the treatment of a child before giving it to a particular preparation, it is necessary to study the instruction well and make sure that the medicine does not have an ototoxic effect.

It should be noted that hearing loss in a child is often a complication of the disease, so you need to timely and completely treat viral and infectious diseases, to provide the patient with maximum peace.

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

[32], [33], [34], [35], [36],

Forecast

Forecasts are favorable in the timely detection of pathology and adequate therapy. In this case, hearing loss in a child will not lead to a delay in development, speech and psychological abnormalities.

Hearing loss in a child is a serious pathological process that can affect the overall development of the child and lead to a complete hearing loss. According to statistics for a thousand newborns, one child has a weakened hearing, and from this one thousand several children may lose their hearing for some reason (trauma, infection, etc.) in the process of growth.

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

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

[37],