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Deafness From Birth

A newborn child with hearing loss may not have any other features or symptoms that would point to hearing loss. That is why babies born in hospitals are usually screened with a test called OAE (Otoacoustic emissions) before discharge from the hospital. This test is simple and takes a couple of minutes. It is quite accurate, though it may miss picking up the hearing loss in a few patients.

Every child born in the western world undergoes screening for hearing loss after birth. This is called Universal Neonatal Hearing Screening.

Parents are also under the misconception that hearing loss cannot be diagnosed accurately when the baby is a few days old. However, accurate testing is possible even at this stage. Usually, the tests would be repeated after a gap of 3 months.

If a child has a confirmed hearing loss at or after birth, then it is important to quantify the loss. A series of tests are carried out to determine the severity of hearing loss. These include Impedance Audiometry (tympanometry), Free Field Audiometry, OAE, BERA, ASSR etc. The results of all these tests provide the physician with information that will help him guide the parents regarding the management of the hearing loss. This may either be the fitting of hearing aids if the hearing loss is on an average less than 70dB (decibels), or maybe Cochlear Implant surgery if the hearing loss is greater. This is because hearing aids are not able to provide adequate benefit to persons with hearing loss greater than 70dB.

After the fitting of hearing aids, the child is helped with auditory verbal therapy (AVT) to help quicken recovery from the deficit in hearing. Follow up for a few weeks to months will show if the child is benefitting along expected lines. If the child does not improve as expected, then reassessment would be required to decide regarding the need for Cochlear Implantation.

Some children have a mild degree of hearing loss and this is usually due to fluid in the middle ear, which is known as middle ear effusion or Otitis Media with Effusion (OME). This is usually treated with medication. Sometimes the fluid persists inspite of medication and such children may require a minor surgical procedure called Grommet Insertion, in which a small button like tube called a ventilation tube or grommet is inserted onto the eardrum. This leads to resolution of the fluid. Grommets usually fall off from the eardrum after a period of between 6-12 months. Their removal is usually not necessary. Some of these children may be mouth breathers or snorers and they may require an additional procedure known as Adenoidectomy or Tonsillectomy.

A small percentage of the total number of children born with hearing loss have a congenital deformity or mal-development of the external & middle ears. Such kids present with a deformed pinna and small or absent ear canals. Hearing tests will confirm a conductive hearing loss of between 50-60 dB. These children require a BAHA or Bone Anchored Hearing Aid.

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