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Unilateral sensorineural deafness in children.

I H Kielmovitch1, W H Friedman

  • 1Center for Pediatric Otolaryngology, Park Central Institute.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|December 1, 1988
PubMed
Summary
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Perilymphatic fistula may cause unilateral sensorineural deafness in children. Exploratory tympanotomy is crucial for diagnosing and treating this condition, even with normal preoperative tests.

Area of Science:

  • Pediatric Otolaryngology
  • Neurotology
  • Auditory Medicine

Background:

  • Unilateral sensorineural deafness in children often stems from heredity, viral infections, or trauma.
  • The exact incidence of perilymphatic fistula (PLF) in pediatric unilateral hearing loss remains undetermined.
  • Diagnostic options for inner ear issues in children are limited, complicating PLF diagnosis.

Observation:

  • Four pediatric patients (ages 5-15) with rapid, progressive unilateral sensorineural hearing loss underwent surgical exploration.
  • Preoperative evaluations including fistula tests, ENG, CT scans, and ABR yielded normal results in all cases.
  • Overt perilymphatic fistula was confirmed in only one of the four surgically explored children.

Findings:

  • Exploratory tympanotomy is the definitive diagnostic method for perilymphatic fistula.

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  • This surgical procedure can potentially halt or reverse hearing loss and stop middle ear-cranial cavity communication.
  • Despite normal non-invasive tests, PLF may be present and require surgical confirmation.

    • Implications:

    • Exploratory tympanotomy should be considered in pediatric cases with a suggestive history of unilateral hearing loss.
    • The potential benefits of timely surgical intervention outweigh the risks and morbidity associated with the procedure.
    • Early diagnosis and treatment via tympanotomy are vital for managing pediatric sensorineural hearing loss potentially caused by PLF.