Fluctuating and/or progressive sensorineural hearing loss in children

Area of Science:

• Pediatric Audiology
• Otolaryngology
• Developmental Pediatrics

Background:

• Sensorineural hearing loss (SNHL) in children presents challenges for medical management, hearing aid selection, and educational planning.
• Progressive or fluctuating hearing loss can continue despite multidisciplinary interventions.
• Variations in audiologic techniques and middle ear issues can influence threshold measurements.

Purpose of the Study:

• To analyze the patterns of threshold variation in pediatric sensorineural hearing loss.
• To identify the prevalence of progressive and fluctuating SNHL in children.
• To explore predictors of hearing threshold fluctuation and progression.

Main Methods:

• Retrospective analysis of audiometric data from 229 children (ages 1-19.9) with SNHL.
• Inclusion criteria: mild SNHL, threshold variation ≥10 dB, no concurrent middle ear disease.
• Follow-up averaged 4.9 years with a mean of 10.3 audiograms per child.

Main Results:

• Of 365 ears with significant variation, 6% showed purely progressive loss, 57% fluctuating with progression, and 37% intermittent fluctuation.
• Contralateral fluctuation occurred in 91% of cases if one ear fluctuated.
• Contralateral progressive SNHL occurred in 67% of cases if one ear progressed.

Conclusions:

• Pediatric SNHL frequently exhibits fluctuating or progressive patterns, necessitating careful monitoring.
• Hearing loss in one ear is a strong predictor of similar changes in the contralateral ear.
• Further research into demographic and audiometric predictors is warranted for personalized intervention strategies.