Causes of Childhood Hearing Loss

The most common reason for hearing loss in children is known as otitis media. This is an inflammation of the middle ear caused by bacteria, resulting in fluid building up behind the eardrum.

Symptoms of a middle ear infection include:

• Tugging or pulling at the ear
• Earache
• Fever
• Fluid draining from the ear
• Mild deafness
• Delayed speech
• Difficulties in sleeping
• Loss of appetite

Often otitis media begins after an infection in the upper respiratory system or a sore throat. If the infection is caused by bacteria, this may spread to the middle ear where infected fluid builds up behind the eardrum, a membrane that separates the outer ear from the middle ear. When fluid builds up in the middle ear, sound does not travel well through the fluid, so a child may experience hearing difficulties and normal speech will sound like a whisper. Occasionally the ear drum will burst, releasing the fluid and actually making the child feel better. Burst eardrums typically heal themselves after a few days.

To diagnose an ear infection we use a microscope to look into the ear where we can spot the infection. This is treated with antibiotics, nasal spray and/or painkillers if needed, and your child should feel better after a few days. If the symptoms persist and your child remains sick, call your doctor. Sometimes another antibiotic will need to be prescribed.

Once the infection clears, the fluid may remain in the middle ear but usually it disappears within three to six weeks. On rare occasions, the fluid stays in the middle ear and the child will continue to suffer from middle ear infections. At this point, a surgical procedure is recommended to place a small ventilation tube in the eardrum to improve air flow and prevent fluid build up. This ventilation tube stays in the ear for several months.

If your child experiences recurrent otitis media it is very important to make sure that they do not have enlarged adenoids. The adenoids are small glands in the nasopharynx, a region that is connected to the middle ear by the Eustachian tube. If the adenoids are hyperplastic (abnormal enlargement or inflammation) they might block the Eustachian tube. Fluid build-up behind the eardrum or recurrent otitis media may result. Other symptoms of adenoid hyperplasia are snoring, sleep apnea (abnormal pauses in breathing during sleep), breathing through the mouth during the day, or nasal sounding speech. If your child is negatively affected by their adenoids, it is necessary to remove them through a surgical operation under general anaesthesia.

After removing the adenoids and draining fluid behind the eardrum, the middle ear can heal. Your child’s hearing will improve immediately along with their speech, while snoring will disappear after a few days. You will also notice your child is more awake in the morning and no longer feels so tired throughout the day. Lastly, they will experience fewer otitis media infections and common colds.

An allergy to dust mites or mould is another cause of recurrent otitis media. In this case the mucous membrane of the Eustachian tube and the middle ear is affected by the allergy through your child’s nose. The mucous membrane produces fluid which builds up in the middle ear. In addition to removing the adenoids, it is also necessary to treat the allergy very carefully through allergen avoidance or medication.

How can ear infections be prevented?

• Wash your hands frequently to prevent the spread of germs.
• Separate sick children and limit day-care exposure to others when your child or your child’s playmates are sick.
• Passive smoking is a risk factor; therefore avoid exposing your child to cigarette smoke.

Other reasons for hearing loss in children:

• Glue ear: After a middle ear infection thick fluid can fills up in the ear, which may require an operation to insert a ventilation tube in the eardrum.
• Ear wax: Sometimes an ear is filled up with wax, which can be cleaned out by your doctor.
• Otits externa or ‘Swimmer’s ear’: An inflammation of the skin of the external ear, it is often caused from bacterial or fungal infection. The skin of the ear canal will swell and become painful; hearing loss may also occur.
• Foreign body: Occasionally a foreign object like a small toy or object becomes stuck in the external canal.

Remember, if your child suddenly seems to hear less than normal or starts speaking louder than usual, turns up the TV or music, or experiences fluid discharge from the ear, a visit to your ENT doctor is strongly recommended.

Reference:

www.uptodate.com