Hearing impairment in a 5 year old child

The masked bone conduction thresholds ("]" for the left and "[" for the right) are normal, implying that the inner ear is working normally.[...]he has hearing loss despite normal inner ear function; in other words, there is a discrepancy between what his ears are "capable&qu...

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Bibliographic Details
Published in:BMJ (Online) 2014-04, Vol.348 (apr03 1), p.g2468-g2468
Main Authors: Ronan, Natalie, Barrett, George
Format: Article
Language:English
Subjects:
Antibiotics
Audiometry
Child, Preschool
Children & youth
Cold remedies
Diagnosis, Differential
Ear diseases
Eardrum
Ears & hearing
Hearing Aids
Hearing loss
Hearing Loss - etiology
Humans
Infections
Male
Medical screening
Otitis Media with Effusion - complications
Otitis Media with Effusion - diagnosis
Otitis Media with Effusion - therapy
Parents & parenting
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Summary:The masked bone conduction thresholds ("]" for the left and "[" for the right) are normal, implying that the inner ear is working normally.[...]he has hearing loss despite normal inner ear function; in other words, there is a discrepancy between what his ears are "capable" of hearing (the bone conduction), and what they are "actually" hearing (the air conduction).Long answer Children with cleft palate, Down's syndrome, or other craniofacial abnormalities have anatomical differences that predispose them to impaired eustachian tube function and otitis media with effusion, meaning that spontaneous resolution is less likely and a period of watchful waiting is unnecessary and unhelpful.Long answer Medical treatments such as antihistamines, antibiotics, and decongestants are of no benefit and should not be used to treat this condition. 2 6 Attempts should be made to reduce risk factors, including parental smoking, and autoinflation (repeated opening of the eustachian tube using Valsalva maneouvres) may be used during the active monitoring period in primary care. 5 7 Because early spontaneous resolution is unlikely if the symptoms persist beyond three months, this is the point at which treatment is usually offered.NICE guidelines recommend against routine adjuvant adenoidectomy in the absence of recurrent upper respiratory tract infection, 5 although recent evidence suggests that it may help reduce the risk of recurrence, especially in children over 4 years of age. 8 Hearing aids provide good symptomatic relief, last for the duration of the condition, and are generally well tolerated by children. 9 They are especially useful when parents do not want the child to be given a general anaesthetic.
ISSN:0959-8138
1756-1833
1756-1833
DOI:10.1136/bmj.g2468