Hearing Loss And Deafness

Question 1

How is hearing loss in children defined
What is the incidence at birth
By 9 year of age

Answer 1

Hearing loss >=40db
Whisper at 20db
Normal conversation 50-70
Incidence at birth 1/1000
9year of age 2-3/1000
Means can have normal hearing at birth pass the screening test and develop later

Question 2

Hearing tests

Answer 2

ABR can do from birth in a sleeping baby do this one if you fail the screening test
Typanometry A is normal B is flat means middle ear problem wax grommets
C = eustracion tube problem can do from birth
VROA best overall hearing test can do from 6-9/12 of age
Does not give individual ear info
Pure tone audiometry from 3 year of age

Question 3

Hearing problems in infants

Answer 3

Diagnose before 6months and treat amplification and early intervention NEED BOTH

Question 4

Birth screening for hearing 3

Answer 4

1 SN deafness
2 conductive deafness
3 auditory neuropathy
If HIGH RISK DONT DO SCREENING DO ABR

Question 5

BILATERAL SN HEARING LOSS. Causes 3

Answer 5

Genetic 50%
30% Syndrome eg DS, or autosomal recessive Connexin 26
Environmental 50% TORCH, prem NICU, meningitis. Drugs
Structural cochlear problem or LVA
Middle ear problem petrous bone

Question 6

Ix of bilateral hearing loss SN

Answer 6

1 kidney, Thyroid TORCH Connexin 26
MRI cochlear or the large vestibular acqeduct
ECG long QT syndrome in severe hearing loss
EYES check to improve outcome

Question 7

Amplification hearing aides or cochlear implant

Don’t use alone need early intervention to make meaningful outcomes

Answer 7

If hearing worse than 75Db severe /profound loss
Cochlear implants help
If better than 75 hearing aides more natural hearing
Need help keeping them on
Signing

Question 8

Conductive hearing loss

Answer 8

Ix renal USS spinal X-ray CTscan of the petrous bone 5 years

Treatment bone conductors
And eyes
And ? Surgery age 5-6 petrous temporal bone CTscan avoid before 5 years

Question 9

CMV

Answer 9

10% hearing loss can be symptomatic or a symptomatic
Eye and neurodevelopment assessments
Check HC small head

Question 10

Hearing tests

Answer 10

HyperBr needing exchange transfusion

Persistent pulmonary hypertension

Question 11

Meningitis and hearing loss

When should you test

Answer 11

1 bacterial 30% have hearing loss esp HI
2 viral 15%
Check hearing as soon as well enough DONT WAIT 6 weeks

Question 12

Parents adjustment to the diagnosis of deafness is the strongest indicator of the child’s emotional outcome

Answer 12

True