Hearing loss in a child is a condition characterized by progressive or persistent hearing loss. The disease can be diagnosed in a child at any age, even in newborns. Currently, there are many predisposing factors that lead to a decrease in sound perception. All of them are divided into several large groups and determine the characteristics of the pathology.
The characteristic of hearing loss in a child is presented below.
Any form of the disease is characterized by a lack of response to the sound coming from the toys, to the whisper or voice of the mother. Among other things, in the clinical picture there are disorders of mental and speech development. A diagnostic feature is a check by a pediatric otolaryngologist, it is based on certain measures through a special set of tools. In addition to establishing the correct diagnosis, they are aimed at determining the stage of hearing loss. Based on the etiological factor, therapy can be physiotherapeutic, drug and surgical. Often, treatment requires an integrated approach.
Classification of this disease
Hearing loss in a child is characterized by incomplete hearing loss, in which the patient perceives sounds quite illegibly. Doctors note four degrees of hearing loss. Speech, depending on the degree of amplification, is becoming less and less understood. The last degree is on the border with complete hearing loss.
The disease is divided by duration:
- acute - hearing deteriorates gradually, no more than a month has passed since the beginning of this process; occurs in most cases as a result of an injury or infection;
- sudden flow - appears very quickly, up to a couple of hours;
- subacute - from the time of hearing impairment, one to three months have passed;
- chronic - the patient has been ill for more than three months; this stage is the worst treatable.
At the site of inflammation of the auditory analyzer, hearing loss is classified:
- neural
- conductive;
- mixed;
- sensory;
- sensorineural.
If a child's hearing loss develops in only one ear, this means that the disease is one-sided. Bilateral - in the presence of pathology in both ears.
Degrees of pathology
Experts, determining the severity of the pathology, take the results of speech and tonal audiometry as the basis:
- Hearing loss of 1 degree in a child (with fluctuations from 26 to 40 dB). The child can clearly understand and hear colloquial speech at 4-6 meters, and perceives a whisper at a distance of one to three meters. With constant noise, speech analysis is difficult.
- Hearing loss of 2 degrees in a child (with fluctuations from 41 to 55 dB). The patient understands the conversation in two to four meters, from one meter - a whisper.
- Hearing loss 3 degrees in a child (with fluctuations from 56 to 70 dB). The kid distinguishes the conversation in one or two meters, whispering in this case becomes illegible.
- Hearing loss of 4 degrees in children (with fluctuations from 71 to 90 dB). Speaking is not heard at all.
If the auditory threshold is above 91 dB, doctors diagnose deafness. In some cases, having established the causes of the disease, it turns out to take the necessary measures that can slow down the progression of the hearing impairment process.
Sensorineural hearing loss in children
This form of pathology is a combination of the neural and sensory types. Inflammation can occur in one or several sections: the auditory nerve, the inner ear. Most often, this kind of hearing loss in a child develops due to injuries that were received during childbirth and when exposed to viruses or toxins.
This pathological form most often occurs in children, about 91% of cases. In seven percent of situations, conductive defects are detected. Least of all mixed hearing loss.
Conducted hearing loss in young patients
This form of the disease, as conductive, is a disorder that spreads in the outer ear, middle ear bones and eardrum. In such a situation, specialists identify the first and second degrees of hearing loss.
The causes of the conductive type, as a rule, are:
- sulfuric cork;
- traumatic disorders of the eardrum;
- inflammation in the ear;
- strong exposure to noise;
- in the cavity of the middle ear, a bone grows.
Diagnosing hearing problems in the very first stages makes it possible to prevent deafness and other dangerous complications. Therapy of this disease should be carried out by a qualified specialist, able to choose an individual approach to such a problem and the course of treatment.
Causes of hearing loss in children
Currently, specialists are not able to provide accurate information about why this disease may appear. However, after a thorough analysis and study of this pathology, a certain list of alleged source factors was revealed:
- Heredity - an infant most often, due to this factor, acquires a mixed and neurosensory type of pathology. In this case, the child has irreversible changes in the organ of hearing, which, in turn, are bilateral defects in the perception of sounds. According to statistics, in 80% of cases, the disease appears in isolation from other disorders, in other cases, along with genetic syndromes.
- The negative influence of factors that affect the intrauterine development of the fetus. At the end of the first trimester of pregnancy, auditory organs form. When a woman transfers serious infectious diseases during a given period of time, this can negatively affect the features of the development of children's hearing organs.
- Various injuries during childbirth.
- Leading a woman an unhealthy lifestyle during pregnancy and neglecting timely visits to a specialist.
- Diabetes mellitus in a woman.
- If the blood of the fetus and mother are incompatible, a Rhesus conflict can occur, resulting in defects in the formation of the baby’s organs.
- Premature birth. Of course, with premature birth, the child's hearing organs are fully formed. But hypoxia that occurs during childbirth can adversely affect the auditory organs.
- The negative consequences of the patient’s infectious diseases - in some cases, the baby may have complications in the form of herpes, measles, rubella, etc.
It should be noted that the causes of the disease can also be:
- adenoids;
- sulfuric cork;
- eardrum defects;
- otitis;
- tonsillitis;
- various injuries of the hearing organs.
In some cases, the pathological process in adolescents can be affected by constant listening to music at high volume.
The following are the symptoms of hearing loss in a child.
Symptoms of this pathology in babies
The main importance in recognizing children's hearing loss is given primarily to the observation of parents. They should be alerted by the absence in the child of up to four months of reaction to loud sounds; in four to six months there are no pre-speech vocalizations; at seven to nine months, the baby is not able to establish a sound source; in one or two years there is no vocabulary.
Older babies may not have a reaction to spoken language or whispering from behind; the child can ask the same thing several times; do not respond to the name; do not distinguish surrounding sounds; speak louder than necessary, and also read lips.
In children with hearing loss, systemic speech underdevelopment is noted : there is a polymorphic defect in the pronunciation of sounds and sharply manifested difficulties in differentiating phonemes by ear; extremely limited vocabulary, gross distortions of the syllabic-verbal structure, lack of a formed lexico-grammatical speech system. All this causes the formation of different types of dyslexia and dysgraphia in schoolchildren with weak hearing.
Hearing loss during treatment with ototoxic drugs is usually diagnosed in children two to three months after this and is bilateral in nature. Hearing may decrease to 40-60 dB. In a child, the first symptoms of hearing loss are vestibular disorders (dizziness, unstable gait), tinnitus.
Features of the diagnosis of the disease
During pregnancy, the main diagnosis is a screening procedure. If children are at risk of congenital hearing loss, they should undergo a particularly thorough examination. With a clear perception by a newborn baby of loud sounds, such involuntary reactions are noted as inhibition of the sucking reflex, blinking, etc. In the future, in order to identify defects, a procedure such as otoscopy is performed.
For a good study of auditory function in an older child, audiometry is necessary. For preschoolers, there is a game form of this diagnosis, for schoolchildren, tone and speech audiometry. If a specialist detects certain deviations, then electrocochleography is used, through which a site of damage to the organ of hearing can be detected.
In addition to the otolaryngologist, pediatric hearing loss is also diagnosed by otoneurologists and audiologists.
Is childhood hearing loss treated?
With carefully carried out diagnostic procedures and timely and comprehensive treatment of hearing loss in children, the likelihood of gaining a full hearing can be significantly increased. I must say that at the beginning of this pathology there is a chance to bring the hearing to normal.
When the disease is accompanied by sensorineural disorders, the implantation of sensors will be required to restore. Naturally, the time to see a specialist also affects a positive outcome: the sooner the treatment procedures are started, the greater the chances of a successful outcome.
Treatment of this disease in babies
The set of methods for the rehabilitation and treatment of young patients with hearing loss are divided into surgical, functional, physiotherapeutic and medical. In some situations, it is enough to carry out simple measures (removing a patient’s sulfur plug or foreign body in the ear) to restore hearing.
In children, conductive hearing loss due to defects in the integrity of the auditory ossicles and eardrum usually requires hearing-improving surgery (prosthetics of the auditory ossicles, tympanoplasty, myringoplasty, etc.).
The drug treatment of hearing loss in children is based on the degree of hearing loss and the etiological factor. If hearing loss is reduced due to vascular disorders, drugs are prescribed that improve the blood supply to the inner ear and cerebral hemodynamics (Bendazolum, Eufillin, Papaverine, nicotinic acid, Vinpocetin). With the infectious origin of childhood hearing loss, non-toxic antibiotics become first-line drugs. If intoxication is acute, then detoxification, metabolic and dehydration therapy, as well as hyperbaric oxygenation, are carried out.
Non-pharmacological treatment methods for children with hearing loss are pneumatic massage of the ear membrane, electrophoresis, acupuncture, endoural ultraphonophoresis and magnetotherapy.
In many situations, the only rehabilitation method for patients with sensorineural hearing loss is hearing replacement. If there are appropriate indications, then cochlear implantation is performed in small patients .
The comprehensive rehabilitation for this disease includes the help of a child psychologist, a defectologist, a sign teacher and a speech therapist.
Prevention and prognosis of children's hearing loss
If the child was diagnosed with hearing loss in a timely manner, this makes it possible to prevent a lag in the development of intelligence, a delay in the development of speech, and the occurrence of psychological complications of a psychological nature.
With early treatment, in most cases it turns out to achieve a stable state and successfully carry out rehabilitation manipulations.
Prevention of hearing loss in young patients includes the exclusion of perinatal-type risk factors, vaccination, refusal to use ototoxic drugs, and prevention of pathologies of ENT organs. To ensure the harmonious development of a child whose hearing loss has been identified, it is necessary to accompany him at all age stages with comprehensive medical and pedagogical measures.
Such a pathology in a child is a rather serious problem, causing a fragile body severe discomfort. Therefore, you should be careful about children and do not postpone a visit to the doctor if there are any suspicions.
We examined the degree of hearing loss in children and methods of treating this pathology. Health to you and your children!