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Pediatric fluctuating sensorineural hearing loss: problems in medical management
E A Dinces1, S Yang, A O Balogun
1Department of Otolaryngology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 10467, USA.
The Laryngoscope
|February 24, 2001
Summary
Most pediatric fluctuating sensorineural hearing loss (FSNHL) is idiopathic. Autoimmune inner ear disease (AIED) was suggested in some cases, but treatment was often delayed or not pursued.
Area of Science:
- Pediatric Otolaryngology
- Audiology
- Immunology
Background:
- Fluctuating sensorineural hearing loss (FSNHL) in children presents diagnostic and management challenges.
- Autoimmune inner ear disease (AIED) is a potential, though less common, cause of pediatric hearing loss.
Purpose of the Study:
- To review the diagnosis and management of pediatric FSNHL.
- To specifically investigate cases potentially related to AIED.
Main Methods:
- Retrospective chart review of 40 children with progressive hearing loss.
- Identified 22 children meeting criteria for FSNHL (threshold variations ≥15 dB).
- Analyzed audiology, medical history, and laboratory data.
Main Results:
- 15 of 22 FSNHL cases were idiopathic.
- 3 cases showed positive lymphocyte transformation tests (LTT) suggestive of AIED.
- 4 cases had middle ear fistula; average fluctuation was 29.1 dB over 4.95 years.
Conclusions:
- Idiopathic causes dominate pediatric FSNHL.
- Limited treatment was initiated for suspected AIED despite positive LTTs, often due to parental/physician reluctance or loss to follow-up.
- Significant audiometric fluctuations were observed across all identified groups.