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Causes of pediatric sensorineural hearing loss: yesterday and today
1Department of Otolaryngology, Children's Hospital, Boston, Mass 02115, USA.
Insights
Sensorineural hearing loss (SNHL) in children is common, with identifiable causes in over 68% of cases. Reconsidering extensive workups and leveraging infant screening can improve diagnosis of pediatric SNHL.
Area of Science:
- Pediatrics
- Otolaryngology
- Genetics
Background:
- Sensorineural hearing loss (SNHL) is a significant concern in pediatric populations.
- Identifying the etiology of SNHL in children is crucial for timely intervention and management.
- Previous reports on the causes of pediatric SNHL may not reflect current trends.
Purpose of the Study:
- To determine the current prevalent causes of sensorineural hearing loss in children.
- To compare contemporary causes of pediatric SNHL with historical data.
- To evaluate the diagnostic yield of current workup protocols for pediatric SNHL.
Main Methods:
- Retrospective review of medical records for children diagnosed with SNHL.
- Study period: January 1, 1993, to September 30, 1996.
- Patient cohort: 301 children (aged 1 week to 18 years) evaluated for SNHL at a tertiary care children's hospital.
Main Results:
- A definite or probable cause for SNHL was identified in 68.1% of the 301 children.
- Commonly identified factors included family history, prematurity, perinatal complications, syndromes, congenital anomalies, meningitis, and prenatal maternal factors.
- Syndromes frequently cited in literature, like Waardenburg syndrome, were rare (<1%). Computed tomographic scanning was the most valuable diagnostic tool.
Conclusions:
- Sensorineural hearing loss is a frequent condition among children.
- Current extensive diagnostic workups for pediatric SNHL may require reevaluation.
- Enhanced infant screening programs and targeted evaluations (e.g., cytomegalovirus testing) can improve diagnostic accuracy for pediatric SNHL.
Objective:
To ascertain the present common causes of sensorineural hearing loss (SNHL) in children and compare them with those of previous reports.
Design:
A retrospective review of the medical records for all children with a diagnosis of SNHL seen from January 1, 1993, through September 30, 1996, at our institution.
Setting:
A tertiary care children's hospital.
Patients:
Three hundred one children, aged 1 week through 18 years, who presented for evaluation of SNHL.
Results:
Of the 301 children, 68.1% had a definite or probable cause of their SNHL identified; 18.9%, 1 or more possible causes; and 31.9%, no obvious cause. A family history of SNHL or prematurity and/or complicated perinatal course was found in 28.6% of patients. Named syndromes, multiple congenital anomalies, meningitis, or prenatal maternal factors, including maternal prenatal substance abuse, were present in another 38.5%. However, syndromes commonly reported to be associated with SNHL, such as Waardenburg syndrome, were seen in less than 1% of patients. The average age at diagnosis was 3.02 years for the bilateral moderate or worse SNHL; for unilateral SNHL, the average age was 3.97 years. The most useful diagnostic study was computed tomographic scanning.
Conclusions:
Sensorineural hearing loss is fairly common in children. Extensive workups, often without clear direction, should be reconsidered based on the children with SNHL who otolaryngologists are now seeing. Infant screening programs, although identifying many children earlier, will also provide the opportunity to fine-tune the evaluation (ie, cytomegalovirus titers and/or cultures at birth), increasing the diagnostic yield.