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Unilateral hearing loss in children
P E Brookhouser1, D W Worthington, W J Kelly
1Boys Town National Research Hospital, Omaha, NE 68131.
Insights
Early onset unilateral sensorineural hearing loss (USNHL) in children is linked to auditory and learning challenges. Early identification and intervention are crucial for improving outcomes in affected children.
Area of Science:
- Pediatric Audiology
- Neuroscience
- Developmental Psychology
Background:
- Unilateral sensorineural hearing loss (USNHL) in children can impact development.
- Previous reports indicate potential deficits in auditory skills, psycholinguistic abilities, and academic performance.
Purpose of the Study:
- To review a series of children and adolescents with unilateral sensorineural hearing loss (USNHL).
- To analyze the characteristics, etiologies, and associated challenges of USNHL in a pediatric population.
Main Methods:
- Retrospective review of 324 children and adolescents with documented USNHL.
- Classification of hearing loss severity based on speech frequency thresholds.
- Analysis of diagnostic age, laterality, etiology, and associated scholastic/behavioral issues.
Main Results:
- USNHL affected the left ear in 52% and the right in 48% of cases.
- Hearing loss severity varied, with high-frequency losses in 28% and anacusis in 15%.
- Common etiologies included uncertain causes (34.8%), hereditary factors (12.6%), and head trauma (10.8%).
- 31% of children experienced scholastic or behavioral problems.
Conclusions:
- Early onset USNHL in children is associated with significant auditory and psycholinguistic deficits.
- A substantial proportion of children with USNHL face academic and behavioral challenges.
- Early identification and intervention strategies for USNHL are essential for mitigating long-term effects.
Abstract:
Recent reports suggest that early onset, severe unilateral sensorineural hearing loss (USNHL) in children may be associated with significant deficits in auditory and psycholinguistic skills and school performance. This report reviews a consecutive series of 324 children and adolescents (202 males, 122 females) with documented USNHL evaluated at the Boys Town National Research Hospital. The left ear was affected in 168 (52%) and the right ear in 156 (48%). Based on speech frequency threshold averages (i.e., 500, 1000, and 2000 Hz), the losses were classified by severity as follows: borderline, 43 (13%); mild, 51 (16%); moderate, 40 (12%); severe, 19 (6%); profound, 31 (10%), and anacusic, 50 (15%). The remaining 90 children (28%) had high frequency losses (i.e., above 2000 Hz). The mean and median age of diagnosis were 8.78 years and 7.75 years. Temporal bone imaging studies, auditory brainstem responses (ABRs), and vestibular evaluations were performed on selected cases. Etiology was uncertain in 34.8% of cases, while hereditary factors (12.6%), head trauma (10.8%), and perinatal risk factors (10.7%) were the most commonly identified etiologies. Thirty-one percent of the children had scholastic or behavioral problems in school. A concerted effort aimed at early identification and intervention in cases of USNHL is warranted.