Risk group for hearing loss

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Risk group for hearing loss and deafness

infectious viral diseases of the mother during pregnancy (rubella, influenza, cytomegalovirus or herpes virus infection, toxoplasmosis); toxicosis of pregnancy;

intrauterine birth trauma;

hyperbilirubinemia (more than 200 µmol/l);

hemolytic disease of the newborn;

birth weight less than 1500 g;

ototoxic drugs taken by the mother during pregnancy;

gestational age more than 40 weeks;

hereditary diseases in the mother, accompanied by damage to the auditory analyzer.

Newborns from this risk group are observed by a pediatrician together with an otorhinolaryngologist, who examines them at 1, 4, 6 and 12 months and conducts a sound reaction test.

On the recommendation of an otorhinolaryngologist - impedance measurement with acoustic reflex, consultation with an audiologist.

Careful monitoring of the development of the auditory analyzer.

Avoid prescribing aminoglycosides and ototoxic drugs (furosemide, quinine, Sofradex ear drops, Anauran, Garazon).

Observation up to 18 years of age.

Risk group for developing anemia

disturbance of uteroplacental circulation, placental insufficiency (toxicosis, threat of miscarriage, post-term pregnancy, hypoxia, exacerbation of somatic and infectious diseases):

fetomaternal and fetoplacental bleeding;

deep and prolonged iron deficiency in the body of a pregnant woman;

premature or late ligation of the umbilical cord;

children with constitutional anomalies;

malabsorption syndrome, chronic intestinal diseases.

Pediatrician up to 3 months 2 times a month.

Complete blood count at 3, 6, 12 months. At an earlier date according to indications.

Study of serum iron, total iron-binding capacity of serum (TIBC).

Consultations with specialized specialists (cardiologist, gastroenterologist) according to indications.

Early introduction of nutritional supplements (juice, fruit puree, minced meat).

When artificial feeding, adapted formulas containing iron are recommended.

Prescription of ferrotherapy after confirmation of iron deficiency.

Follow-up up to 1 year.

Risk group for developing sudden death syndrome.

negative attitude of the mother towards the child;

unfavorable living conditions;

alcoholism, parental smoking:

low educational level of the family;

young age of mother;

prematurity, birth weighing less than 2000 g;

children in the first 3 months of life who have suffered acute illnesses;

children with intrauterine infection;

children with congenital malformations of vital organs.

During prenatal or primary care of a newborn, find out all possible addresses of the child’s residence.

Observation by a pediatrician at least once a week during the first month of life, once every 2 weeks until the age of one year.

Observe sick children under 1 year of age daily until recovery.

Inform the head of the pediatric department about children from this risk group.

Consultations of assistants of the department of the medical academy.

Sanitary educational work with families.

Do not put your baby to sleep on his stomach.

Do not use tight swaddling, do not overheat the baby.

Do not smoke in the room where the child is.

The crib must be in the same room as the parents.

Maintaining natural feeding in the first 4 months of life.

Dynamic observation of a child under 1 year of age should be documented in the form of epicrises at 3, 6, 9, 12 months and submitted to the head of the pediatric department for review.

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Risk group for IUI and hearing loss.

I read the certificate from the RD, for the pediatrician... And it was emphasized there that “yes”. Audio test is normal. On what basis were we included in this group? I really can’t, my heart skips a beat with fear.

You probably have some kind of pain. there were infections. so they wrote it like this

Hope so. Just before giving birth, I had an acute respiratory infection.

At least your audio test is normal, but when I arrived from the maternity hospital I read in the certificate “Risk of IUI, grade 2 hearing loss.” roared in her voice! I thought why didn’t they tell me anything at the maternity hospital? After some time, I realized that the child heard normally. I later asked the midwife why they wrote it that way, and she said, “The device must have broken down, that’s why it showed it that way.” and I almost went crazy!

They would at least warn and explain... Today the pediatrician is supposed to come to our house... now I can’t wait... I’ll torture!

so something like that is written. Not a single doctor said anything about this for a year. Everyone writes - she’s healthy. I think they write to everyone

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Can a 1.5 month old child not respond to all sounds? Or is it hearing loss? (we are at risk for hearing loss)

does a reaction appear in the form of freezing, stopping crying to the voice;

whether the child recognizes his mother’s voice by the end of the first month of life;

does a 3-4 month old child turn his head towards the sound of a toy or voice;

does a sleeping child wake up or flinch at loud noises?

Is there a further enrichment of the child’s babble, the appearance of new syllables by the age of 10 months.

Source: http://otvet.mail.ru/question/

Baby's hearing: are there any problems?

The problem of diagnosing hearing loss and deafness has been and remains relevant both medically and socially. It is of particular importance when it comes to children, since the formation of speech depends on the state of the child’s hearing.

Yakov Sapozhnikov

Professor of the Department of Pediatric Otorhinolaryngology of the Russian State Medical University, Doctor of Medical Sciences.

Let's start with terminology. There are two types of hearing impairment: deafness and hearing loss.

Typically, deafness is a degree of hearing loss in which a person cannot perceive speech audibly, even with the use of hearing aids or other means of sound amplification, but such patients can hear some very loud sounds. The absolute impossibility of perceiving any sounds is rare.

Hearing loss is a hearing loss of varying degrees of severity, in which the perception of speech is difficult, but is still possible when certain conditions are created (approximation of the speaker to the deaf person, the use of a hearing aid or other sound-amplifying equipment).

Hearing loss and deafness are divided into three groups: hereditary, congenital and acquired.

According to statistics from the World Health Organization, the number of children with hearing impairments in the Russian Federation currently exceeds. It is believed that for every 1000 normally hearing newborns, there is one child with severe hearing loss.

The reasons leading to an increase in the number of hard of hearing and deaf children are: the widespread use of ototoxic antibiotics (damaging the organ of hearing, mainly nerves), an increase in the general background radiation and an increase in ear malformations, an increase in the number of viral diseases, alcohol and other intoxication during pregnancy. The development and formation of the human hearing organ begins in the first weeks of intrauterine development and continues throughout the entire period of pregnancy.

Special studies have shown that the auditory function matures in parallel with the formation of the structures of the hearing organ already in the prenatal period. From the 20th week of pregnancy, when external sound stimulation begins to cause a change in the rhythm of the fetal heartbeat, the internal structure and functioning of the hearing organ can be compared with those in adults.

Newborns can already distinguish characteristics of sound such as frequency, intensity and time sequence.

During the 1st month of life, further improvement of the auditory system occurs and the innate adaptability (adaptation) of a person’s hearing to speech perception is revealed. Therefore, it is believed that language learning begins from the moment of birth.

Rehabilitation of children with hearing impairments

Hearing impairment occurs in 1-2% of newborns and young children.

It is known that the first 2 years of a child's life are in many ways the most important for the development of speech, cognitive and emotional skills. Depriving a child of an auditory-speech environment can have an irreversible impact on his subsequent ability to use the capabilities of his residual hearing. It has been proven that in such cases, children have difficulty catching up and their potential abilities for speech, reading and writing are rarely fully developed. The optimal period for the beginning of the directed development of auditory function corresponds to the very first months of life (up to 4 months). If hearing aids begin to be used after 9 months of age, audiological and pedagogical correction may be less effective. Taking into account the above is especially important due to the fact that, according to statistics, hearing impairment in children in 82% of cases develops in the 1st–2nd year of life, i.e. in the pre-speech period or during the development of speech.

The determining factor in the problem of rehabilitation of children with impaired hearing is the time of beginning work with a hard of hearing or deaf child. Therefore, a correct assessment of the state of auditory function is of particular importance in young children, since a timely diagnosis makes it possible to begin their rehabilitation and placement in a speech environment as early as possible.

Modern development of technology and the creation of appropriate diagnostic equipment make it possible to detect hearing impairment at any age, even in newborns.

In newborns and young children, hearing impairment is mainly hereditary and congenital.

Hearing loss and deafness: risk factors

When determining indications for hearing tests in children of this age group, risk factors for hearing loss and deafness should be taken into account. Identification of such factors increases the sensitivity of screening 1 hearing research methods by 35 times and ensures the identification of over 75% of newborns with a pronounced degree of hearing loss.

Risk factors for hearing loss and deafness include:

• unfavorable course of pregnancy: toxicosis of pregnancy, threat of miscarriage and premature birth, Rh conflict between mother and fetus, gestosis (complication of pregnancy, manifested by increased blood pressure, the appearance of edema, protein in the urine), uterine tumors, maternal diseases during pregnancy (rubella, influenza , ARVI, cytomegalovirus infection, etc.), maternal intake of antibiotics from the group of aminoglycosides: STREPTOMYCIN, MOIOMYCIN, NEOMYCIN, KANAMYCIN, GEITAMICIN, AMICACIA, TOBRAMYCIN, etc., which have an ototoxic effect as a side effect; alcohol and other intoxication, exposure to radiation;
• pathological births: premature, rapid, prolonged, forceps, cesarean section, partial placental abruption, breech and pelvic presentation and other pathologies leading to asphyxia (cessation of oxygen supply) and intracranial injury to the fetus;
• pathology of the newborn period: severe jaundice caused by hemolytic disease of the newborn (a condition associated with the destruction of Rh-positive red blood cells of the fetus by antibodies of the Rh-negative mother), prematurity, weight up to 1500 g, congenital malformations (including ENT organs), etc. ;
• risk factors in early childhood: sepsis - the appearance and proliferation of pathogenic bacteria in the blood of a newborn; diseases accompanied by fever, viral infections (rubella, chickenpox, measles, mumps, whooping cough, scarlet fever, influenza); meningoencephalitis - inflammation of the brain and its membranes; diseases of the ENT organs; traumatic brain injuries; use of ototoxic antibiotics; anesthesia, etc.;
• hereditary pathology: the risk of having a child with hearing loss if one of the parents is ill is 50%. In the vast majority of cases, hereditary hearing loss is sensorineural (in this case, sound perception is impaired, i.e. the sound reaches the auditory receptor cells, but they or the auditory pathways do not work). The following forms of hereditary sensorineural hearing loss are distinguished:

1. Isolated, i.e. without other concomitant pathology.
2. Associated with various concomitant pathologies, such as:

• abnormalities of the outer ear;
• eye diseases;
• diseases of the musculoskeletal system;
• skin lesions;
• kidney diseases
• pathologies of the nervous and endocrine systems.

Diagnosis of hearing impairment

The first assessment of the child’s hearing status is given by a pediatrician or otolaryngologist based on a survey of parents.

Questionnaire for parents

1. Does your baby flinch from loud noises in the first 2-3 weeks of life?
2. Does a child's freezing of his voice appear at the age of 2-3 weeks?
3. Does a 1 month old baby turn to the sound of a voice behind him?
4. Does a 1-3 month old baby perk up to his mother's voice?
5. Does a 4 month old baby turn his head towards a sounding toy or voice?
6. Does a 1.5-6 month old baby react by screaming or opening his eyes wide to sharp sounds?
7. Does a 2-4 month old baby hum?
8. Does babbling turn into babbling in a child aged 4-5 months?
9. Do you notice the appearance of new (emotional) babbling in your child, for example, when parents appear?
10. Does a sleeping child become disturbed by loud noises and voices?
11. Do you notice the appearance of new sounds in a child aged 8-10 months and what ones?

So, from newborn to 4 months, parents are asked whether an unexpected loud sound awakens a sleeping child, whether he shudders and cries at such sounds. A positive answer assumes normal hearing.

For 4-7 month old children, they find out whether they make attempts to turn towards the source of sound and what the nature of their voice is.

At 7-9 months, parents can evaluate the child’s ability to identify the source of sound.

At the age of 9-12 months, questions addressed to parents concern the localization of sounds outside the child’s field of vision and the nature of his speech sounds. And finally, at the age of 1-2 years, the child’s ability to hear without seeing the speaker is determined, as well as what his response sounds and vocabulary are.

To identify behavioral reactions during a hearing screening study in children under 1 year of age, various sounding toys, sound reactometers that reproduce intermittent sounds of the same frequency, as well as narrowband and broadband noise of varying intensity are used.

At the same time, various reactions of the child are recorded: the unconditioned orienting reflex (Moro reflex), when the child spreads his arms and makes hugging movements with them, etc.; freezing of the body or “freezing” of the child; movement of the limbs, spreading the arms and legs to the sides; turning the head towards or away from the sound source; facial grimaces (furrowing eyebrows, squinting eyes); sucking movements; slight trembling of the child’s whole body upon awakening; wide eye opening; change in breathing rhythm, pulse, etc. Attention is paid to three types of responses: reflex reactions, hearing (behavior in response to a sound signal) and listening (listening, turning the baby towards the sound source).

In newborns, the study is carried out in the stage of light sleep (1 hour before feeding or 1 hour after feeding). To do this, use noise with an intensity of 90 dB SPL (the intensity indicated on the sound test is achieved when the device is located at a distance of 10 cm from the ear) in the automatic signal interruption mode. The signal presentation frequency is 3 Hz.

This test is performed by a doctor. The child must be placed on a firm mattress so that the head lies free and straight, and the arms and legs remain free. It should be remembered that it is difficult for a newborn child to turn his head from one side to the other, since the occipital protuberance interferes with him. Therefore, after each turn of the head towards the sound, it is necessary to lay the child’s head back on the back of the head. Based on the fact that most children more often respond to sound with their right ear (“right-handed”), the test should be performed starting with stimulation of the right ear, and then the left. In young children, there may be a disappearance of the response to frequently repeated stimuli, so it is advisable to limit the number of stimulus presentations to 2-3 and increase the time of the inter-stimulus interval.

The reaction is considered positive if the newborn responds to the sound of one of the specified reactions three times. This technique allows you to get a qualitative answer to the question: “Does the child hear or not hear?”

In children over 7 months of age, the motor reaction is characterized by relative speed.

The described technique for studying hearing using behavioral screening can also be used for children older than 9-10 months, but they are presented with both noise signals and tone messages with a frequency of 500, 2000 and 4000 Hz and an intensity of 90, 65, 40 dB SPL in continuous mode . At this age, children respond to sound stimuli by quickly turning their heads towards the sound source.

In case of unilateral hearing loss, the child responds only towards the healthy ear, regardless of the location of the sound source.

If a child is suspected of having hearing loss, he or she is referred to a hearing therapy center (office) for an audiological examination using objective methods. These methods include:

1. Acoustic impedance measurement, which is a registration of acoustic resistance (or acoustic conductivity) of the sound-conducting apparatus of the auditory system. Acoustic impedance measurement involves recording a tympanogram and acoustic reflex. This allows you to determine the presence of hearing loss and its nature.
2. The method of recording evoked otoacoustic emissions (EOAE) is used when conducting screening examinations of newborns and children of the first years of life. VOEA is an extremely weak sound vibration generated by the inner ear in response to sound stimulation, which can be recorded in the external auditory canal using a highly sensitive microphone.
3. Computer audiometry using SVP is based on recording evoked biopotentials of the auditory system resulting from acoustic stimulation of the hearing organ. Using computer audiometry, the objective hearing threshold is determined using auditory evoked potentials.

A hearing screening test for newborns with risk factors for hearing loss and deafness, based on the registration of HAE and CVEP, is an ideal model for audiological screening at present. To implement it, it is necessary not only to be equipped with the appropriate equipment, but also to combine the efforts of the staff of maternity hospitals, neonatologists, pediatricians and audiologists (doctors involved in the examination and correction of hearing) in order to maximize the coverage of newborns with audiological screening.

It is generally accepted that parents or other family members are the first to notice possible hearing problems in a child. However, many of them do not know what to do. In this case, information and literature provide invaluable assistance, focusing the attention of parents on the problem and ways to solve it.

An appropriate level of diagnosis of childhood hearing loss cannot be achieved without close cooperation between neonatologists, local pediatricians, and audiologists. It is necessary that the neonatologist of the maternity hospital, department of pathology of newborns and nursing of premature infants take into account the presence of risk factors for hearing loss and deafness in each child (discussed above).

If at least one of the listed factors is present, the neonatologist notes in the newborn’s individual chart: “At risk for hearing loss,” indicating the factor. Upon discharge from the hospital, a conversation is held with the parents, orienting them to the earliest possible examination of the child.

After discharge, such children are taken for follow-up at a local clinic by a pediatrician, who introduces parents to a questionnaire reflecting normal reactions to sounds in children of different ages.

The presence of risk factors for hearing loss and deafness, the child’s lack of reaction to sound, delayed speech and intellectual development are grounds for referring the child for an audiological examination (hearing test). Early detection of hearing impairment and timely implementation of appropriate treatment and/or hearing aids, as well as systematic educational work for the deaf, reduce the impact of hearing loss and deafness on the speech and intellectual development of the child.

1 Screening studies are carried out on all newborns to maximize the complete detection of this pathology.

Photo source: Shutterstock

Comments on the article

Katerina, it’s great that they were able to give the child the opportunity to hear normally. I also suggested that my husband buy a hearing aid, since he constantly asks questions several times during a conversation and watches the TV almost at full volume. He agreed, went to a special center, where they fitted him with a hearing aid (he bought ReSound Vea), so now at least we communicate as before - normally, without asking again. And my husband now feels more comfortable with a hearing aid.

November 14:01

I can say that even such a diagnosis today does not mean a complete collapse of life or a catastrophe. The main thing here is that the doctor is experienced, reacts in a timely manner and prescribes the correct treatment. Our neighbor, for example, has a child who is hard of hearing. Once I got into a conversation with her about what and how. She says there are no major problems at the moment. We picked up an imported hearing aid, if I'm not mistaken, from RiSound. The child hears normally and goes to a regular kindergarten. You see, you shouldn’t get upset ahead of time, science doesn’t stand still.

August 19:48

With the permission of the author, link to an article on the topic of deafness in children http://medpost.com.ua/kak-slyshit-vash-rebenok-gluhota-u-detej/

August 1:27

I also encountered this problem. The first baby was born healthy, but the second had hearing problems. The ENT said the ear canals are clean. Diagnostics did not reveal any inflammation. Hearing diagnostics showed that the left ear could not hear, the sound passed through the right ear, but the second ear could not be measured, he woke up and began to fidget. Let's go again, and then they will refer you to other specialists to determine the degree of deafness. Of course, I hope for the best, like any mother.

March 5:49

It is very useful to know in the comments that the article is good. I'm just happy. What kind of idiots write this? No one has written what to do, what to do in such a situation. Who recovered how - also 0.

March 5:16

The article is good, useful for those who are faced with this problem.

Modern examination methods and timing are indicated. Those who are worried will find some pointers for themselves, or will continue to search for a solution to the problem.

October 25:15

my child cannot see or hear, the doctor delivered the baby for 3 months. what should I do

The article is very instructive! My daughter noticed at 4 months that her son did not react to sounds, and the visit to the ENT specialist went with a bang, they rattled a rattle and that’s it, she hears! Don’t make things up, mommy, the baby hears. We haven’t done all the examinations yet, alas, the baby does not respond to sound... we will take the next steps!! and we hope that everything will be fine.

the article is very good. We had our hearing checked at the maternity hospital - everything was fine, the pediatrician came and said every time that the child was healthy and everything was fine. 2 weeks later I took the card from the registry and read that after each examination the pediatrician wrote in the card that we had hearing loss. Not a word was said to me.

September 10, 2011

My son is 1.5 months old, they did a hearing test at the maternity hospital, he passed it, but at the clinic he didn’t (the left one hears, but the right one doesn’t), although he reacts to sound from the right, what should I do?

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Hearing loss - what is it, causes, symptoms, treatment of hearing loss 1, 2, 3, 4 degrees

Hearing loss is a phenomenon of incomplete hearing loss in which the patient has difficulty perceiving and understanding sounds. Hearing loss makes communication difficult and is characterized by the inability to detect sound that originates near the ear. There are different degrees of hearing loss, in addition, this disease is classified according to the stage of development.

What is hearing loss?

Hearing loss is a permanent weakening of hearing, in which the perception of sounds from the surrounding world and speech communication are impaired. The degree of hearing loss can vary from slight hearing loss to complete deafness. .

It is scary to lose the ability to hear this world, but 360 million people today suffer from deafness or various hearing impairments. 165 million of them are over 65 years of age. Hearing loss is the most common hearing disorder associated with age-related changes.

Causes

Hearing impairment is said to occur when a person has a deterioration in the perception of sounds that are usually perceived by other people. The degree of impairment is determined by how much louder the sound must become compared to the normal level for the listener to begin to distinguish it.

In cases of profound deafness, the listener cannot distinguish even the loudest sounds produced by an audiometer.

In most cases, hearing loss is not congenital, but an acquired disease. Many factors can lead to hearing loss:

• viral infections. The following infectious diseases can cause hearing complications: ARVI, tonsillitis, measles, scarlet fever, AIDS, HIV infection, mumps.
• inflammatory processes of the middle and inner ear;
• poisoning;
• taking certain medications;
• circulatory disorders in the vessels of the inner ear;
• age-related changes in the auditory analyzer;
• long-term exposure to noise. Residents of megalopolises are susceptible to increased noise pollution, especially those living in industrial zones, near airfields or near major highways.
• sulfur plugs;
• hypertension;
• atherosclerosis;
• tumors;
• otitis externa;
• various eardrum injuries, etc.

Depending on the cause, hearing loss can occur in a mild form or have a detailed clinical picture with a rapid transition to a severe degree.

Symptoms of hearing loss

The main symptom of hearing loss is a deterioration in the ability to hear, perceive and distinguish a variety of sounds. A person suffering from hearing loss cannot hear some of the sounds that a person normally perceives well.

The lower the severity of hearing loss, the greater the range of sounds a person continues to hear. Accordingly, the more severe the hearing loss, the more sounds a person, on the contrary, cannot hear.

The main symptoms of hearing loss include:

• noise in ears;
• increasing the volume of the TV or radio;
• asking again;
• Conducting a telephone conversation while listening only with a specific ear;
• decreased perception of children's and women's voices.

Indirect signs of hearing loss are difficulty concentrating when talking to an interlocutor in a crowded or noisy place, the inability to recognize speech on the radio or car horns when the car engine is running.

Classification by level of damage

There are classifications of hearing loss that take into account the level of damage, the degree of hearing impairment and the period of time during which hearing impairment develops. With all types of hearing loss, varying degrees of hearing loss can be observed - from mild hearing loss to complete deafness.

Thus, all of the listed types of this disease have several degrees of hearing loss. They can be either mild or severe.

Degrees of hearing loss: 1, 2, 3, 4

Depending on the threshold of hearing (the minimum level of sound that a person’s hearing aid can detect), it is customary to distinguish 4 degrees (stages) of a chronic disease in a patient.

There are several degrees of hearing loss:

1st degree

• 1st degree – hearing loss, which is characterized by a lack of sensitivity to sounds from 26 to 40 dB;

At a distance of several meters, provided there are no extraneous sounds, a person does not experience any problems with hearing and distinguishes all words in a conversation. However, in a noisy environment, the ability to hear the speech of interlocutors is clearly deteriorated. It also becomes difficult to hear whispers at a distance of more than 2 meters.

Level 2 hearing loss

• 2nd degree – hearing loss, which is characterized by a lack of sensitivity to sounds from 41 to 55 dB;

In people at this stage, their hearing begins to rapidly decline; they can no longer hear normally even in the absence of extraneous noise. They cannot distinguish whispers at a distance of more than a meter, and ordinary speech at a distance of more than 4 meters.

How this can manifest itself in everyday life: a patient will ask the interlocutor much more often than healthy people. Accompanied by noise, he may not even hear speech.

3rd degree

• 3rd degree - hearing loss, which is characterized by a lack of sensitivity to sounds from 56 to 70 dB;

If the patient experienced a gradual increase in problems and did not receive proper treatment, in this case the hearing loss progresses and grade 3 hearing loss appears.

Hearing loss 4 degrees

• Grade 4 - hearing loss, which is characterized by a lack of sensitivity to sounds from 71 to 90 dB.

At this stage, the patient cannot hear a whisper at all, and can barely distinguish spoken speech only at a distance of no further than 1 meter.

Hearing loss in children

Hearing loss in a child is a disorder of auditory function in which the perception of sounds is difficult, but to one degree or another intact. Symptoms of hearing loss in children may include:

• lack of reaction to the sound of a toy, maternal voice, call, requests, whispered speech;
• absence of humming and babbling;
• violation of speech and mental development, etc.

Currently, there is no exact data regarding the causes that can cause hearing loss in children. At the same time, as this pathological condition was studied, a number of predisposing factors were identified.

• Negative influence of external factors on intrauterine development of the fetus.
• Somatic diseases in the mother. Such diseases include diabetes mellitus, nephritis, thyrotoxicosis, etc.
• Unhealthy lifestyle of the mother during pregnancy.
• Complications after illnesses. Most often, children develop hearing loss after suffering from rubella, influenza infection, mumps, measles, syphilis, herpes, etc.

To ensure that your child does not suffer from hearing loss, the following rules should be followed:

• Paying attention to your health during pregnancy
• Expert treatment and follow-up care for middle ear infections
• Avoiding exposure to very loud noises

All methods of treatment and rehabilitation of children with hearing loss are divided into medications, physiotherapeutic, functional and surgical. In some cases, simple procedures (removal of wax plugs or removal of a foreign body in the ear) are sufficient to restore hearing.

Disability due to hearing loss

Special techniques for hearing restoration, developed and available today, make it possible to restore hearing to people suffering from degree 1-2 hearing loss as quickly as possible. As for the treatment of hearing loss of 2 degrees, here the recovery process looks much more complicated and takes longer. Patients with grade 3 or 4 hearing loss wear a hearing aid.

Disability group 3 is established upon diagnosis of bilateral hearing loss of degree 4. If the patient is diagnosed with stage 3 disease, and hearing aids provide satisfactory compensation, then disability in most cases is not determined. Children with hearing loss of degrees 3 and 4 are assigned a disability.

Diagnostics

Timely diagnosis of hearing loss and initiation of therapy at an early stage allows it to be preserved. Otherwise, as a consequence, persistent deafness develops, which cannot be corrected.

In case of hearing problems, it is necessary to apply a wide range of diagnostic tools, to find out, firstly, why the hearing loss occurred; the symptoms of this disease may also indicate the possible nature of partial deafness.

Doctors are faced with the task of fully characterizing the nature of the onset and course, type and class of hearing loss; treatment can only be prescribed after such a comprehensive approach to analysis.

Treatment of hearing loss

Treatment for hearing loss is selected depending on its form. In the case of conductive hearing loss, if the patient has a violation of the integrity or functionality of the eardrum or auditory ossicles, the doctor may prescribe surgery.

Today, many surgical methods of hearing restoration for conductive hearing loss have been developed and practically implemented: myringoplasty, tympanoplasty, prosthetics of the auditory ossicles. Sometimes it is possible to restore hearing even if you are deaf.

Sensorineural hearing loss can be treated conservatively. Medications are used that improve blood circulation in the inner ear (piracetam, Cerebrolysin, etc.). Treatment of hearing loss involves taking medications that relieve dizziness (betagistine). Physiotherapy and reflexology are also used. For chronic sensorineural hearing loss, hearing aids are used.

Drug treatment for hearing loss may include the following:

• Nootropics (Glycine, Vinpocetine, Lucetam, Piracetam, Pentoxifylline). They improve blood supply to the brain and the auditory analyzer area, stimulate the restoration of cells in the inner ear and nerve roots.
• Vitamins B (pyridoxine, thiamine, cyanocobalamin in the form of preparations Milgamma, Benfotiamine). They have a targeted effect - they improve nerve conduction and are indispensable for optimizing the activity of the auditory branch of the facial nerve.
• Antibiotics (Cefexime, Suprax, Azitrox, Amoxiclav) and NSAIDs (Ketonal, Nurofen, Ibuklin). Prescribed when the cause of hearing loss is purulent otitis media - inflammation of the middle ear, as well as other acute bacterial diseases of the hearing organs.
• Antihistamines and decongestants (Zyrtec, Diazolin, Suprastin, Furosemide). They help eliminate swelling and reduce the production of transudate in inflammatory pathologies of the ear, leading to hearing impairment.

Operation

There are several types of operations used in the treatment of pathology:

• If hearing loss is caused by a malfunction of the auditory ossicles, surgery is performed to replace them with synthetic analogues. As a result, the mobility of the bones increases, and the sick person’s hearing is restored.
• If hearing loss is caused by a violation of the integrity of the eardrum, then myringoplasty is performed, replacing the pathologically altered eardrum with a synthetic one.

How to treat hearing loss with folk remedies

Folk remedies have become widespread in the treatment of hearing loss. Today, many of them show amazing effectiveness. Before using any traditional recipes, you should definitely talk to your doctor to avoid the negative consequences of self-medication.

1. Infusion of calamus roots. A dessert spoon of dry crushed calamus roots is steamed with 0.5 liters of boiling water in a glass or ceramic vessel, covered with a lid, wrapped and allowed to brew for three hours. The filtered infusion is taken three times a day, half an hour before meals. The course of treatment is 1 month, which is repeated after a two-week break.
2. You need to instill 3 drops of natural almond oil, alternating ears every day. The course of treatment lasts a month. This procedure helps improve hearing.
3. Onion compress. A piece of onion is heated and wrapped in gauze. This mini-compress is inserted into the ear overnight.
4. Calamus root infusion: crushed root (1 tbsp) in 600 ml of boiling water with infusion for at least 2.5 hours - drink 50 ml before each meal.
5. You can also use grated garlic in combination with camphor oil when treating sensorineural hearing loss with folk remedies. You will need one small clove of garlic and 5 drops of oil. They need to be mixed thoroughly, moisten the bandage flagella with the resulting mixture and place them in the ear canal for 6-7 hours.

Prevention

The main rule for preventing hearing loss is to avoid dangerous situations and risk factors. It is important to promptly identify diseases of the upper respiratory tract and treat them. Any medications should be taken only as prescribed by a specialist, which will help avoid the development of many complications.

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Hearing loss in children

Hearing loss in children is hearing loss of varying severity, making it difficult to perceive speech and surrounding sounds. Symptoms of hearing loss in children may include a lack of reaction to the sound of a toy, a mother’s voice, calls, requests, or whispered speech; absence of humming and babbling; disorders of speech and mental development, etc. Diagnosis of hearing loss in children includes otoscopy, audiometry, acoustic impedance measurement, registration of otoacoustic emissions, and determination of auditory EP. Taking into account the causes and type of hearing loss in children, medication and physiotherapeutic treatment, hearing aids, functional otosurgery methods, and cochlear implantation can be used.

Hearing loss in children

Hearing loss in children is a disorder of auditory function in which the perception of sounds is difficult, but to one degree or another preserved. Hearing loss in children is the subject of study in pediatric otolaryngology, audiology, and otoneurology. In Russia, the number of children and adolescents with hearing loss and deafness is more than 600 thousand, while in 0.3% of patients hearing impairment is congenital, and in 80% of children it occurs in the first three years of life. Hearing loss in childhood is closely related to the development of the child’s speech function and intelligence, so early identification and rehabilitation of children with hearing loss is an important task in practical pediatrics.

Classification of hearing loss in children

Taking into account the etiological condition, hereditary, congenital and acquired hearing loss in children is distinguished. Depending on the location of the damage in the auditory analyzer, it is customary to distinguish:

• sensorineural (sensorineural) hearing loss in children, developing as a result of damage to the sound-receiving apparatus: the inner ear, auditory nerve or central parts of the auditory analyzer.
• conductive hearing loss in children, which develops as a result of damage to the sound-conducting apparatus: the outer ear, eardrum and middle ear (auditory ossicles).
• mixed hearing loss in children, in which the functions of sound transmission and sound perception are simultaneously impaired.

In the structure of childhood hearing loss, sensorineural lesions are detected in 91% of cases, conductive in 7%, and mixed in the rest.

The severity of hearing loss in children is assessed based on speech and pure-tone audiometry data:

• 1st degree (26-40 dB) – the child hears spoken speech from a distance of 4-6 m, whispered speech from a distance of 1-3 m; does not distinguish between speech against background noise and distant speech;
• 2nd degree (41-55 dB) - the child distinguishes spoken speech only from a distance of 2-4 m, whispered speech - from a distance of 1 m;
• 3rd degree (56-70 dB) – the child hears spoken speech only from a distance of 1-2 m; whispered speech becomes inaudible;
• 4th degree (71-90 dB) – the child does not distinguish spoken speech.

An increase in the hearing threshold above 91 dB is regarded as deafness.

Based on the time of onset of hearing loss, a distinction is made between prelingual (occurring before the development of speech) and postlingual (occurring after the appearance of speech) hearing loss in children.

Causes of hearing loss in children

Hereditary sensorineural hearing loss in children in most cases is transmitted in an autosomal recessive manner; less often - according to the dominant type. In this case, the child has irreversible, non-progressive changes in the organ of hearing caused by bilateral impairment of sound perception. The hereditary form of hearing loss occurs in isolation in 80% of children, in other cases it is part of the structure of many genetic syndromes. Of the more than 400 known syndromes that include sensorineural hearing loss in children, the most common are Down syndrome, Patau syndrome, Alport syndrome, Pendred syndrome, Ledparod syndrome, Kleipel-Feil syndrome, and others.

The development of congenital hearing loss in children is facilitated by various kinds of pathological effects on the auditory analyzer in the prenatal period. The greatest danger to the developing organ of hearing of the fetus are infectious diseases suffered by a pregnant woman in the first trimester: rubella, influenza, herpes, measles, toxoplasmosis, cytomegalovirus infection, tuberculosis, syphilis. These and other intrauterine infections, as a rule, lead to damage to the sound-receiving part of the auditory analyzer, and the severity of hearing impairment in children can vary from mild hearing loss to complete deafness.

Congenital hearing pathology in a child can be caused by various chronic diseases of the mother (thyrotoxicosis, diabetes mellitus, anemia, vitamin deficiency), the pregnant woman taking ototoxic drugs (neomycin, streptomycin, gentamicin, kanamycin, etc.), occupational hazards, alcohol intoxication (fetal alcohol syndrome) etc. Often the cause of hearing loss in a child is hemolytic disease, fetal asphyxia, intracranial birth injuries, and hearing defects. Prematurity (birth weight of a child less than 1500 kg) is a risk factor for the development of congenital hearing loss in children.

The causes of acquired hearing loss in children affect the normally formed hearing organ already in the postnatal period. Earwax, foreign bodies in the ear, perforation of the eardrum, adenoids, chronic rhinitis, tonsillitis, recurrent otitis media, injuries to various parts of the ear and other diseases of the ENT organs can lead to decreased hearing in a child. In addition, hearing loss in children can be a complication of common infections (ARVI, mumps, scarlet fever, diphtheria, encephalitis, meningitis, neonatal sepsis), hydrocephalus, traumatic brain injuries involving the pyramid of the temporal bone, drug intoxication, and vaccination of children. The development of acquired sensorineural hearing loss is facilitated by teenagers' passion for listening to loud music through headphones.

Symptoms of hearing loss in children

The main role in recognizing hearing loss in children is given to the observation of parents. Adults should be wary if a child under 4 months does not react to loud sounds; by 4-6 months there are no pre-speech vocalizations; by 7-9 months the child cannot determine the source of the sound; 1-2 years old lacks vocabulary.

Older children may not respond to whispered or spoken language spoken to them from behind; do not respond to your name; asking the same thing several times, not distinguishing the sounds of the environment, speaking louder than necessary, “reading lips.”

Children with hearing loss are characterized by systemic underdevelopment of speech: there is a polymorphic disorder of sound pronunciation and pronounced difficulties in auditory differentiation of phonemes; extreme limitation of vocabulary, gross distortions of the sound-syllable structure of the word, immaturity of the lexical and grammatical structure of speech. All this causes the development of various types of dysgraphia and dyslexia in hearing-impaired schoolchildren.

Hearing loss during therapy with ototoxic drugs in children usually manifests itself 2-3 months after the start of treatment and is bilateral. Hearing loss can reach dB. The first signs of hearing loss in children are often vestibular disorders (gait instability, dizziness), and tinnitus.

Diagnosis of hearing loss in children

At the screening stage, the leading role in diagnosing hearing loss in children is assigned to a neonatologist, pediatrician and pediatric otolaryngologist. Particular attention in the first year of life should be paid to identifying congenital and hereditary hearing loss in children at risk. In well-hearing newborns, in response to sounds, various unconditioned reactions are normally recorded (blinking, pupil dilation, Moro reflex, inhibition of the sucking reflex, etc.). From 3-4 months, a child’s ability to localize a sound source can be determined. An otoscopy is performed to identify pathology of the outer ear and eardrum.

To study auditory function in young children with suspected hearing loss, play audiometry is used; in schoolchildren, speech and tone threshold audiometry and tuning fork hearing testing are used. Objective audiological diagnostic methods include acoustic impedance measurement (tympanometry), recording of auditory evoked potentials, and otoacoustic emissions. To determine the location of damage to the auditory analyzer, electrocochleography is used. An in-depth examination of auditory function allows us to judge the degree and nature of hearing loss in children.

Upon receipt of evidence that a child has hearing loss, further management of the patient is carried out by audiologists, otoneurologists, and hearing prosthetists.

Treatment of hearing loss in children

All methods of treatment and rehabilitation of children with hearing loss are divided into medications, physiotherapeutic, functional and surgical. In some cases, simple procedures (removal of wax plugs or removal of a foreign body in the ear) are sufficient to restore hearing.

In case of conductive hearing loss in children caused by a violation of the integrity of the eardrum and auditory ossicles, hearing-improving surgery is usually required (myringoplasty, tympanoplasty, prosthetics of the auditory ossicles, etc.).

Drug therapy for sensorineural hearing loss in children is carried out taking into account the etiological factor and the degree of hearing loss. In case of hearing loss of vascular origin, drugs are prescribed that improve cerebral hemodynamics and blood supply to the inner ear (vinpocetine, nicotinic acid, papaverine, aminophylline, bendazole). If hearing loss in children is of an infectious nature, non-toxic antibiotics are the first-line drugs. In case of acute intoxication, detoxification, dehydration and metabolic therapy, hyperbaric oxygenation are carried out.

In many cases, the only way to rehabilitate children with sensorineural hearing loss is hearing aid. If there are appropriate indications, children with senoneural hearing loss undergo cochlear implantation.

Comprehensive rehabilitation of children suffering from hearing loss includes the help of a speech therapist, teacher of the deaf, speech pathologist, and child psychologist.

Prognosis and prevention of hearing loss in children

Timely detection of hearing loss in children allows one to avoid delayed speech development, lag in intellectual development, and the development of secondary psychological layers. With early treatment for hearing loss in children, in most cases it is possible to achieve stabilization of hearing and successfully implement rehabilitation measures.

Prevention of hearing loss in children includes the elimination of perinatal risk factors, vaccination, prevention of diseases of the ENT organs, and refusal to take ototoxic drugs. To ensure the harmonious development of children suffering from hearing loss, they need comprehensive medical and pedagogical support at all age stages.

Hearing loss in children - treatment in Moscow

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