The auditory pathway starts with the entrance of the sound from the auricle and the external auditory canal, and continues by creating a vibration on the eardrum and transferring this sound to the inner ear through the middle ear ossicles. Sound that comes to the inner ear in the form of mechanical energy is converted into electrical energy by the auditory nerve cells (hair cells) in the inner ear and transmitted to the brain via the auditory nerve. Therefore, hearing loss in children or adults may be caused by a problem in any of these pathways of hearing (outer ear canal, middle ear, inner ear, auditory nerve or the auditory center in the brain).
Hearing loss is very important in children. Speech development in infants or children is only possible with the presence of good hearing. Especially the first 2 years after birth is the most important period for the child’s speech development. With good hearing, the children can recognize sounds, imitate sounds and thus they provide better language development. The higher the level of hearing loss, the worse the speech development and speech development is not possible in advanced losses.
How should hearing problems in children be noticed by their family?
In the first 6 months after birth, if babies do not wake up with noise and do not respond to sounds, it should be suspected. During this period, babies who hear normally react to loud sounds by turning towards the side where the sound comes from and by winking.
In the period between six months and a year, the child is expected to start speaking a little and react to speech sounds coming from outside. If there is a hearing loss, the speech sounds disappear and there is no inclining to the sound source. In the period between one and two years of age, problems such as indifference to sounds coming from outside, failure to respond calling out, and watching TV with loud voice may occur.
What are the most common causes of hearing loss in childhood?
Congenital (hereditary) hearing loss is one of the most common causes. It may appear as a stand-alone hearing loss or may be found along with other diseases (such as vision problems, heart and kidney problems), which is also called syndromic hearing loss.
The mother’s use of medications causing hearing-damage during pregnancy, infections (such as measles, rubella, meningitis, toxoplasma, cytomegalovirus) that the mother had during pregnancy or that the baby had after birth may cause hearing loss.
Acute and chronic otitis media, fluid accumulation in the ear are common causes of hearing loss in infancy and childhood. Apart from these, congenital insufficient development of the outer-middle-inner ear, tumors in the ear, cysts, etc. appear as other causes of hearing loss.
How is hearing loss detected in children?
It is very important for every newborn baby to undergo some hearing screening tests in the first days after birth ort he early detection of congenital hearing loss.
In a baby with suspicion of hearing loss, a complete history should be taken from the family, the baby’s examination, screening tests (such as auto acoustic emission, ABR), other diagnostic audiometric tests, if necessary blood tests, genetic tests, tomography or MRI should be performed.
How should hearing loss be treated?
The sooner hearing loss is detected in babies and children and the treatment is initiated, the more problems that may cur due to hearing loss are reduced or eliminated. Treatment varies depending on the cause of the loss. Antibiotic treatment in middle ear infections, ventilation tube placement into the eardrum if necessary in the presence of fluid in the ear, tympanoplasty surgery in case of a perforation in the eardrum, hearing aid application according to the severity of hearing loss in congenital hearing loss, bionic ear surgery (cochlear implant) in cases where the hearing aid is insufficient are some of the treatment methods.
Our goal is to detect a congenital hearing loss within the first three months, to use hearing aids from 6 months of age, and to perform bionic ear surgery around the age of one year in cases where hearing aids are insufficient (especially in severe hearing losses). In this way, it is possible for children to have normal language and speech development and to attend the same schools with their peers.
