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HEARING IMPAIRMENT OR LOSS

DESCRIPTION

Hearing impairment or loss means a decreased ability or complete inability to hear. Classifications include the following: conductive loss, in which middle-ear bones degenerate and don't transmit sound waves (see Otosclerosis in Illnesses section); sensorineural loss, in which the 8th cranial nerve (the acoustic nerve) is damaged -- often for unknown reasons; and mixed loss, involving both conductive and sensorineural disabilities. The middle-ear bones that conduct sound are involved, as are branches of the 9th cranial nerve that transmit sound to the brain.
Appropriate health care includes:
  • Physician's monitoring of general condition and medications.
  • Surgery for conductive-type deafness (sometimes).
  • Speech therapy and rehabilitation, if necessary.

    SIGNS & SYMPTOMS
    In an infant:

  • Lack of response to environmental sounds--especially startling sounds. In an older child:
  • Difficulty in discriminating (listening selectively) to environmental sounds.
  • Ringing in the ears.
  • Lack of speech or inarticulate speech.

    CAUSES

  • Drugs taken during the mother's pregnancy.
  • Congenital, transmitted as a dominant or recessive genetic trait.
  • Chronic middle-ear infections or spread of infection to the inner ear.
  • Blood-vessel disorders, including hypertension.
  • Head injury.
  • Brain tumor.
  • Blood clot that travels to the acoustic nerve.
  • Multiple sclerosis.
  • Syphilis.
  • Blood-coagulation disorders.
  • Prolonged exposure to sound levels of 85 decibels or above.

    RISK FACTORS

  • Family history of congenital or acquired deafness.
  • Use of drugs, such as streptomycin, tobramycin, quinine, furosemide, ethacrynic acid, or heavy doses of aspirin.
  • Children with hobbies or occupations involving high noise levels, such as rock musicians.

    PREVENTING COMPLICATIONS OR RECURRENCE

  • Your child should avoid prolonged use or overdosage of drugs that cause hearing loss.
  • Obtain medical treatment for underlying disorders that cause hearing loss.
  • Urge your child to avoid prolonged exposure to loud noise. If exposure is unavoidable, the ears can be protected with ear plugs.

    BASIC INFORMATION

    MEDICAL TESTS

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.
  • Laboratory studies, such as blood studies, audiogram, Weber test, Rinne test, skull X-rays (See Glossary for all).

    POSSIBLE COMPLICATIONS

  • Permanent deafness.
  • Delayed language development in a child.

    PROBABLE OUTCOME
    Some conductive hearing loss is curable with surgery. Hearing loss caused by prolonged exposure to loud noise sometimes disappears when the noise is eliminated. Other types of hearing loss are usually permanent.

    TREATMENT

    HOME CARE

  • Contact local rehabilitation facilities for your child to learn sign-language and lip-reading skills.
  • Encourage your child to learn to use and wear a hearing aid, if one is prescribed.
  • Consult your phone company about special audio equipment for your phone.
  • Urge your child to resist the temptation to withdraw socially because of hearing difficulty. Isolation will increase communication problems and frustration, and will make adjustment more difficult.

    MEDICATION

  • Medicine usually is not necessary for this disorder.
  • See Medications section for information regarding medicines your doctor may prescribe.

    ACTIVITY
    No restrictions.

    DIET & FLUIDS
    No special diet.

    OK TO GO TO SCHOOL?

    When appetite has returned and alertness, strength, and feeling of well-being will allow.

    CALL YOUR DOCTOR IF

  • Your child shows signs of hearing impairment.
  • You suspect your child has a hearing loss, especially if the child does not respond to loud noises or direct conversation or if the child must ask others often to repeat themselves or if family members frequently ask if your child's hearing is all right. ‡
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