Pediatric hearing loss: common causes, diagnosis and therapeutic approach

Pediatric hearing loss limits the child ability to develop effective auditory and speech capabilities. Early rehabilitation of hearing loss results in higher levels of linguistic, academic and social skills. To achieve the best outcomes, proper and timely diagnosis is essential. The etiology of hearing loss can be classified according to its nature as sensorineural hearing loss (SNHL), conductive hearing loss (CHL) or mixed hearing loss (MHL). Congenital hearing loss could be genetic or non genetic (acquired), syndromic or non-syndromic. Hearing loss can be classified according to the severity into mild (26-40 dB HL), moderate (41-70 dB HL), severe (71-90 dB HL) and profound (more than 90 dB HL). Management of hearing loss is mainly influenced by the nature, the bilaterality, the severity and the age at diagnosis. Severe to profound bilateral SNHL can be managed by cochlear implantation (unilateral or bilateral), if picked up at early age while mild to moderate bilateral SNHL are easier to manage with conventional hearing aids. CHL has less impact on the speech development of the child. It is usually managed by correcting the underlying etiology such as otitis media with effusion or even surgically in cases of external ear atresia or ossicular malformations. Unilateral SNHL have fortunately no impact on the language development of the child and can be passed undiagnosed until preschool-aged children. The implementation of national newborn hearing screening programs has improved the management of affected children by rehabilitating them at early stages to allow for normal speech development. In this review article, we aim to highlight the most common causes of pediatric hearing loss, their character and presentation and to review the diagnostic and therapeutic approaches of a deaf child.