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Updated: Oct 13, 2026
Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss
Published on: January 25, 2016
Hearing impairment following surgically repaired congenital heart disease in children: a prospective study
Kanittha Sakjirapapong1, Chodchanok Vijarnsorn2, Kanthong Thongyai3
1Pediatrics, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand.
Insights
Congenital cardiac surgery (CCS) in children can lead to sensorineural hearing loss (SNHL), with nearly half experiencing subclinical or overt hearing impairment post-operation. Infants undergoing CCS face a significantly higher risk of developing SNHL.
Area of Science:
- Pediatric Cardiology
- Audiology
- Ototoxicology
Background:
- Congenital cardiac surgery (CCS) poses risks for hearing impairment in children.
- Early detection of sensorineural hearing loss (SNHL) is crucial for intervention.
Purpose of the Study:
- To determine the prevalence of SNHL in children following CCS.
- To identify risk factors associated with postoperative SNHL.
Main Methods:
- Prospective study of children undergoing CCS (2019-2023).
- Pre- and postoperative hearing assessments including conventional audiometry, extended high-frequency audiometry (HFA) or auditory steady-state response (ASSR), and distortion-product otoacoustic emissions (DPOAE).
Main Results:
- Postoperatively, 4.1% of children developed new SNHL, and 10.2% showed subclinical hearing impairment via HFA.
- Abnormal DPOAE was observed in 33.6% of patients, leading to an overall ototoxicity prevalence of 47.9%.
- Infants under 1 year undergoing CCS had a significantly higher risk of postoperative SNHL (adjusted OR 18.5).
Conclusions:
- Routine audiological surveillance is recommended for children post-CCS, particularly for infants.
- Early identification of SNHL and subclinical hearing loss enables timely management.
Objectives:
To determine the prevalence of sensorineural hearing loss (SNHL) in children who underwent congenital cardiac surgery (CCS) by using a pre- and postoperative hearing test, a conventional audiometry, an extended high-frequency audiometry (HFA) or auditory steady-state response (ASSR), and distortion-product otoacoustic emissions (DPOAE).
Study Design:
This prospective study enrolled children with CCS in Siriraj Hospital, Thailand, between 2019 and 2023. Conventional audiometry including HFA or ASSR and DPOAE were performed pre- and postoperatively. The patients with bilateral abnormal hearing loss or an incomplete examination were excluded. Collected data included: demographics, cardiac surgery and ototoxic medication. Prevalence of SNHL by conventional audiometry and subclinical hearing impairment by HFA or DPOAE were ascertained, and risks were analysed.
Results:
Ninety-eight patients were eligible for the study. The median age (IQR) was 5.3 (1.5-9.6) years. Fifteen patients (15.3%) had univentricular hearts. The preoperative audiologic test was performed 1 day prior to the CCS. The postoperative test was performed at a median of 4.4 (IQR: 2.7-8.0) months postoperatively. Preoperative unilateral hearing impairments were reported in 17 patients (17.3%). Postoperatively, four patients (4.1%) showed significantly abnormal audiogram (> 25 dB) or 15 dB shift at 250-8000 Hz consistent to a new SNHL. Subclinical hearing impairment by HFA was affected in 10 patients (10.2%). Thirty-three patients (33.6%) had abnormal DPOAE exclusively. Therefore, new SNHL, including subclinical hearing loss, revealed a prevalence of ototoxicity up to 47.9%. Age <1 year at surgery was the independent risk of postoperative SNHL (adjusted OR 18.5, 95% CI 1.2 to 293.8, p=0.04).
Conclusion:
Routine post-CCS audiological surveillance especially CCS in infancy is recommended for early recognition and timely management based on the 43.8% subclinical and the 4.1% SNHL that was found in this study.
Trial Registration Number:
TCTR20200421001.
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