Detecting Hearing Loss in Children (cont.)

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Are any additional tests done during a pediatric hearing evaluation?

A thorough diagnostic test also includes an evaluation of the middle-ear system. The middle ear is the space behind the eardrum and is a common site for ear infections in children.

A tympanogram is a measure of the compliance of the middle-ear system mobility (including the eardrum) and is an objective method for confirming abnormalities of the eardrum or middle ear space, such as

  • fluid behind the eardrum,
  • a hole or perforation of the eardrum, or
  • stiffness of eardrum or middle-ear bones (for example, otosclerosis).

The tympanogram is completed by inserting a probe in the ear and creating a vacuum-tight seal. The air pressure is changed in the ear canal from positive to negative, and the movement of the eardrum is recorded. The amount and shape of the movement can either exclude or signify different problems, as previously listed. The test is fast, objective, and is not painful (although sometimes the insertion of the probe may upset children).

When a loud sound is presented to a healthy ear, the eardrum will contract, a sort of built-in hearing protection mechanism (although it's not very effective). This contraction of the eardrum is called the acoustic reflex. The absence of this reflex can further confirm problems of the middle ear or may help to identify or confirm a hearing loss. Acoustic reflexes are typically evaluated concurrent with the tympanogram.

Many general pediatricians perform this test in their offices as a screening test and to aid in the diagnosis of ear infections or effusions (fluid in the middle ear space).

What happens when hearing loss is detected? What is the treatment for hearing loss in children?

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When hearing loss is identified, a thorough search for its cause must be undertaken. In many situations, the hearing loss can be attributed to an ear infection or to fluid trapped in the middle-ear space. In this situation, the pediatrician can often prescribe antibiotics to treat the infection. If the infection is persistent, or the hearing loss is still present after treatment of the infection, then the child should be referred to a medical doctor who specializes in diseases of the ear and auditory system (an otolaryngologist or ENT). The otolaryngologist will often administer further testing, and in some situations, he or she may recommend additional therapy such as surgery (ear tubes). If the hearing loss is persistent or is related to a nerve or inner-ear problem, the otolaryngologist will often recommend an evaluation by an audiologist for hearing aids and rehabilitative therapy (which includes speech therapy and social integration of the hearing-impaired child).

Medically Reviewed by a Doctor on 2/14/2014

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