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Hearing Loss in Children: From Diagnosis to Treatment


Author:

Amie Gordon-Langbein, DO

Frankford Hospital - Jefferson Health Care System

Medically Reviewed On: July 05, 2001

Have you ever wondered about your child's hearing? Parents or other family members are most often the first to recognize a child's hearing difficulties. Since hearing is one of the primary modalities by which young children acquire new information, any suspicion of a hearing loss in your child warrants attention.

The first four years of your child's life are critical in terms of developing speech and language skills that will last a lifetime. Any degree of hearing impairment can be handicapping since hearing loss can negatively impact the acquisition and perception of speech and language, academic achievement, social and emotional development, and self-esteem. Therefore, it is essential to diagnose and treat childhood hearing problems as early as possible.

How do children hear?
The ear is divided into three parts: the external, middle, and inner ear. The external ear is composed of the external auditory canal, the pinna, and the outer surface of the eardrum (or the tympanic membrane). The middle ear is made up of the tympanic membrane and three small bones, the malleus, incus and stapes. These tiny bones are the smallest bones in the body. The inner ear is composed of the cochlea, which controls hearing, and the vestibular apparatus, which controls balance and equilibrium.

Sound is directed via the external auditory canal to the middle ear. Sound energy is vibrational energy, and when these vibrations reach the tympanic membrane they cause the bones within the ear to vibrate. This vibrational energy is converted to electrical energy within the inner ear. Thousands of tiny hair cells within the cochlea send this electrical energy in the form of nervous impulses along the auditory nerve to the brain. The brain then interprets the meaning of these sounds. Any disruption along this complex pathway can result in a hearing loss.

Are there different types of hearing loss in children?
One method of describing hearing losses in children is based on where along the auditory pathway the problem exists. For example, if there is a problem within the external or middle ears, this can result in a conductive hearing loss. The most common causes of hearing problems in children are conductive hearing losses, and the most common cause is otitis media, or inflammation of the middle ear. Otitis media can be caused by viruses, bacteria, or fungi. Otitis media is associated with fluid within the middle ear space. This fluid interferes with sound transmission and results in a temporary hearing loss. Most conductive hearing losses are corrected with either medical or surgical interventions. Other causes of conductive hearing losses in children include excess wax , foreign bodies in the ear canal, or swelling within the ear canal itself.

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