Unilateral hearing loss in children

Recent reports suggest that early onset, severe unilateral sensorineural hearing loss (USNHL) in children may be associated with significant deficits in auditory and psycholinguistic skills and school performance. This report reviews a consecutive series of 324 children and adolescents (202 males, 122 females) with documented USNHL evaluated at the Boys Town National Research Hospital. The left ear was affected in 168 (52%) and the right ear in 156 (48%). Based on speech frequency threshold averages (i.e., 500, 1000, and 2000 Hz), the losses were classified by severity as follows: borderline, 43 (13%); mild, 51 (16%); moderate, 40 (12%); severe, 19 (6%); profound, 31 (10%), and anacusic, 50 (15%). The remaining 90 children (28%) had high frequency losses (i.e, above 2000 Hz). The mean and median age of diagnosis were 8.78 years and 7.75 years. Temporal bone imaging studies, auditory brainstem responses (ABRs), and vestibular evaluations were performed on selected cases. Etiology was uncertain in 34.8% of cases, while hereditary factors (12.6%), head trauma (10.8%), and perinatal risk factors (10.7%) were the most commonly identified etiologies. Thirty-one percent of the children had scholastic or behavioral problems in school. A concerted effort aimed at early identification and intervention in cases of USNHL is warranted.     

Audiological findings of shunt-treated hydrocephalus in children

47 hydrocephalic children (mean age 10.4 years) were examined on average 7.9 years after initial shunting. The etiology of hydrocephalus was classified into 5 groups as follows: perinatal intraventricular hemorrhage 19, congenital obstructive hydrocephalus 15, intracranial cysts 5, severe intracranial anomalies 4 and central nervous system infections 4 children. Audiological examination included pure-tone audiometry, tympanometry, registration of stapedius reflex thresholds and adaptation. A sensorineural high-frequency hearing loss was found in 18 (38%) of 47 examined shunt-treated hydrocephalic children, and 11 of the losses could be classified as the retrocochlear type. The differences of the mean hearing thresholds between the etiological groups of childhood hydrocephalus were minimal.     

Unilateral sensorineural hearing loss in children less than 15 years of age

1-10 years after the first examination, 56 children below 15 years of age with unilateral sensorineural hearing loss were re-examined with a test-battery consisting of puretone and speech audiometry, stapedius reflex tests, caloric tests, brainstem response audiometry and otoneurological tests. In no case was an acoustic tumour suspected on the basis of the test results. A small progression of the hearing loss occurred in only one ear. In no case did the healthy ears develop hearing loss during the observation period. Diagnostic procedures can in most of such cases be limited to pure-tone audiometry. Follow-up is indicated because some patients require advice considering education and evaluation regarding fitting of a hearing aid.     

Unilateral hearing loss in childhood. An empirical analysis comparing bilateral hearing loss

BACKGROUND: Unilateral cochlear hearing loss is considered as a risk factor for auditory, verbal-communicative, behavioral and academic development. An early diagnosis is therefore necessary. METHOD/PATIENTS: 182 consecutive patients with an age up to 10 years were diagnosed with permanent hearing loss in the mild to profound range in a defined 5-years-period (1.10.1994-30.9.1999) in the Pedaudiologic Outpatient Clinic of the University G?ttingen. Fifty children (27.5%) had a unilateral hearing loss (30 sensorineural, 20 conductive caused by aural atresia with or without microtia), 132 a bilateral one. This paper presents the data of the consecutive series of the 30 sensorineural unilaterally hearing-impaired children (> 25 dB). RESULTS: A slight male predominance was present (53.3%). The left ear was affected in 43.3%, the right ear in 56.7%. In the majority of the cases the hearing loss was severe and profound. The hearing-impairments were diagnosed by the median age of 69.5 months and all aided by the median age of 70 months. The etiology remained unknown in 60 per cent of the cases. Hearing aid acceptance at the first follow-up (on average after 6 months) was found to be 79 per cent. CONCLUSIONS: The data suggest the relevance and necessity of a pedaudiometric prevention. They demonstrate the urgent necessity of a molecular genetic cause investigation. Recessive sensorineural hearing loss with onset in infancy may exist with no antecedent family history.     

Unilateral and mild bilateral hearing loss in children: past and current perspectives

Since the early 1980s, audiologists have become increasingly aware of the potential effect of even mild degrees of hearing loss on the psychoeducational and psychosocial outcomes of children. This review describes some of the key research findings during the past several decades that have led us to our current thinking about unilateral and mild bilateral hearing loss in children. The first section addresses unilateral hearing loss. This is followed by a review of the literature on mild bilateral hearing loss. Specifically, the issues addressed include the significance of permanent mild degrees of hearing loss on children's psychoeducational and psychosocial development and the speech, language, and auditory characteristics of children with mild degrees of hearing loss. Finally, some recommendations regarding the direction of future research are offered. This review is followed by 2 articles summarizing the proceedings of a 2005 workshop convened by the Centers for Disease Control and Prevention (CDC), Early Hearing Detection and Intervention (EHDI) program, and the Marion Downs Hearing Center to address concerns about the underidentification of-- and professionals' apparent lack of awareness of-- permanent unilateral and minimal to mild hearing loss in children.     

Unilateral otosclerosis and noise-induced occupational hearing loss

Unilateral otosclerosis and noise-induced occupational hearing loss The interaction between noise-induced hearing loss and otosclerosis remains unclear and controversial. In the present study, the effect of chronic noise exposure was examined in 31 patients with unilateral otosclerosis. Consideration was given to hearing loss at specific frequencies, the influence of age, and the effect of the size of the air-bone gap. A small, though statistically significant, protective effect of otosclerosis was demonstrated at 4 kHz. This effect was maintained despite advancing age. An apparent inverse relationship was found between the amount of hearing loss and the size of the air-bone gap at 4 kHz, but multiple linear regression analysis suggested that this finding was contaminated by age effects.     

Novel-word learning in children with normal hearing and hearing loss

OBJECTIVE: The goal of this study was to assess performance on a novel-word learning task by normal-hearing and hearing-impaired children for words varying in form (noun versus verb), stimulus level (50 versus 60 dB SPL), and number of repetitions (4 versus 6). It was hypothesized that novel-word learning would be significantly poorer in the subjects with hearing loss, would increase with both level and repetition, and would be better for nouns than verbs. DESIGN: Twenty normal-hearing and 11 hearing-impaired children (6 to 9 yr old) participated in this study. Each child viewed a 4-minute animated slide show containing 8 novel words. The effects of hearing status, word form, repetition, and stimulus level were examined systematically. The influence of audibility, word recognition, chronological age, and lexical development also were evaluated. After hearing the story twice, children were asked to identify each word from a set of four pictures. RESULTS: Overall performance was 60% for the normal-hearing children and 41% for the children with hearing loss. Significant predictors of performance were PPVT raw scores, hearing status, stimulus level, and repetitions. The variables age, audibility, word recognition scores, and word form were not significant predictors. CONCLUSIONS: Results suggest that a child's ability to learn new words can be predicted from vocabulary size, stimulus level, number of exposures, and hearing status. Further, the sensitivity to presentation level observed in this novel-word learning task suggests that this type of paradigm may be an effective tool for studying various forms of hearing aid signal processing algorithms.     

Unilateral sensorineural hearing loss in children and auditory performance with respect to right/left ear differences

A group of children suffering from unilateral hearing loss (UHL) were evaluated. Serological tests were performed and vaccination against mumps was offered if negative. In 43.6% of the cases mumps was the plausible cause but a further 33.3% had positive serological tests for mumps without having had the clinical disease. Due to the long delay in the diagnosis of UHL, the question of mumps as major causative agent can be solved only when the results from prophylactic vaccination become apparent in the future. Thirty children aged 10-16 years underwent further audiological examination in order to detect any difference between right and left UHL. The results of word discrimination scores (PB lists) show the well known superiority of binaural v. monaural hearing but was too crude for a detailed analysis of ear difference. An interrupted speech test in background noise shows, however, that right ear impaired children perform significantly poorer than the left ear impaired and are at risk whenever reverberation conditions are poor.     

Unilateral sensorineural hearing loss in children: cognitive abilities with respect to right/left ear differences

Thirty children (age 10 16 years) suffering from unilateral hearing loss (UHL) were matched with a control group and examined by a battery of psychological tests (verbal and non-verbal subtests) in order to investigate a possible right or left ear difference on cognitive functions. The results confirm that right ear impaired children perform significantly poorer than their left ear impaired counterparts especially in verbal subtests that are sensitive to minor input/processing damages. The data obtained suggest that right ear impaired children are at risk in the educational system.     

Sensorineural hearing loss in children

Sensorineural hearing loss in children, either congenital or acquired, has an incidence of 2-4 per million. Molecular diagnosis of early childhood deafness became available for some types of syndromal and non-syndromal forms and will offer different treatment modalities in the future. Severe to profound sensorineural hearing loss can be effectively treated with cochlear implants. There is evidence of cerebral auditory plasticity under electrical stimulation of the auditory nerve with better performance in early implanted children. Other predicting factors are related to the type of schooling, family support and residual hearing. In the long-term, prelingually deafened children will develop considerable speech perception and production. Children with marginal benefit from hearing aid amplification show significant improvements in speech perception following implantation. Implantation is also possible in cases of cochlear malformation. However, special attention has to be given to the facial nerve, a possible CSF leak and electrode misplacement. Apart from hearing improvement cochlear implants have a positive impact on the family situation, schooling and personal well-being.     

Functional hearing loss in children

This report reviewed 39 school-age children diagnosed as having a functional hearing loss utilizing auditory brainstem response (ABR) audiometry during the past 5 years at the Department of Otolaryngology, Kyushu University Hospital in Japan. Twenty-seven cases were females and 12 were males. Seven cases had a hearing loss unilaterally and 32 bilaterally. Although pure-tone audiometry revealed a variety of audiogram shapes, two-thirds of the cases had a flat or saucer-shaped audiogram with a mild to moderately severe hearing loss. ABR audiometry for the frequencies of 1, 2 and 4 kHz indicated a normal hearing threshold in 65 ears of 35 patients, and mild threshold elevations of at least one frequency in the remaining 6 ears of 4 patients. Three illustrative cases were demonstrated, and a discussion was held regarding the features in audiometric tests, and environmental factors surrounding the children with this condition. We emphasized that the physiological hearing measurement such as ABR audiometry should be performed when any discrepancy was noted between the patient's history and results of pure-tone audiometry, because of not infrequent occurrence of functional hearing loss.     

Functional hearing loss in children

The cases of children diagnosed with pseudohypacusis in the Department of Pediatric Otolaryngology were presented. Probable mechanism of its pathogenesis was described. The main stress was put on its correct diagnosis particularly in children with co-existing organic changes. Diagnosis of pseudohypacusis in children is not problematic provided that the occurence of this disease is taken into consideration during diagnostic procedures.     

Effect of bimodal hearing in Korean children with profound hearing loss

Conclusion. Bimodal hearing with combined acoustic stimulation and electric stimulation could enhance speech performance in deaf patients by residual hearing even though the amount of residual hearing is not enough to be used for communication by amplification. Objectives. The cochlear implant (CI) is a well-known therapeutic option for patients with profound hearing loss. However, deaf patients with a CI still have trouble in localization of sounds and understanding speech in a noisy environment. The aim of this study was to evaluate the benefits of bimodal hearing with a CI in one ear and a hearing aid in the contralateral ear in Korean children with profound hearing loss. Subjects and methods. Fourteen deaf children with residual hearing participated in this study. There were eight male and six female patients, with an age range of 4.6–13.8 years at the time of testing. The test was conducted between 3 months and 4.2 years after cochlear implantation. Speech performance was examined in a noisy environment using Korean word lists. A speech sound and the noise were presented to the child from the front loudspeaker. Results. The results showed that speech performance in a noisy environment was significantly better with bimodal hearing than with a CI alone.     

Characteristics of children with unilateral hearing loss

Objective: The purpose of this study was to describe the clinical characteristics of children with unilateral hearing loss (UHL), examine deterioration in hearing, and explore amplification decisions. Design: Population-based data were collected prospectively from time of diagnosis. Serial audiograms and amplification details were retrospectively extracted from clinical charts to document the trajectory and management of hearing loss. Sample: The study included all children identified with UHL in one region of Canada over a 13-year period (2003–2015) after implementation of universal newborn hearing screening. Results: Of 537 children with permanent hearing loss, 20.1% (108) presented with UHL at diagnosis. They were identified at a median age of 13.9 months (IQR: 2.8, 49.0). Children with congenital loss were identified at 2.8 months (IQR: 2.0, 3.6) and made up 47.2% (n?=?51), reflecting that a substantial portion had late-onset, acquired or late-identified loss. A total of 42.4% (n?=?39) showed deterioration in hearing, including 16 (17.4%) who developed bilateral loss. By study end, 73.1% (79/108) of children had received amplification recommendations. Conclusions: Up to 20% of children with permanent HL are first diagnosed with UHL. About 40% are at risk for deterioration in hearing either in the impaired ear and/or in the normal hearing ear.     

Fluctuating sensorineural hearing loss in children

Childhood sensorineural hearing loss (SNHL) that fluctuates or is progressive enhances parental concern and complicates medical management, hearing aid selection, and individualized educational planning for the affected child. Despite intensive multidisciplinary evaluation and intervention, continued threshold fluctuation or a gradual decline in auditory acuity may proceed unabated in a significant percentage of these youngsters. With the adoption of universal newborn hearing screening mandates by an increasing number of states, any challenges to the accurate determination of auditory thresholds must be addressed within the first few months of life.     

儿童突发性感音神经性聋发病特点分析

目的 :探讨儿童突发性感音神经性聋 (突发性聋 )的发病特点 ,以指导临床诊断与治疗。方法 :总结2 1例 14岁以下突发性聋患儿 (儿童组 )的临床表现及预后等 ,并与 6 7例成年突发性聋 (对照组 )进行对比分析。结果 :儿童组中 11例 (5 2 .4 % )查到可能的病因 ,其中腮腺炎 4例 (19% )、上呼吸道感染 3例 (14 .3% )、耳毒性药物中毒 2例 (9.5 % )、声损伤和代谢性脑病各 1例 ;对照组 19.4 %找到可疑的病因。入院时儿童组听力受损平均88.6dB ,对照组 80 .2dB ,两组差异有统计学意义 (P <0 .0 5 ) ;治疗后儿童组听力平均提高 14 .3dB ,对照组提高37.8dB ,两组差异有统计学意义 (P <0 .0 5 )。结论 :儿童突发性聋的特点多有明确病因 ,其中以病毒感染多见 ,其耳聋程度重 ,预后较成人差