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Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss
Published on: January 25, 2016
Mild impairment of neuro-otological function in early treated congenital hypothyroidism
S C Bellman1, A Davies, P W Fuggle
1Great Ormond Street Hospital for Children NHS Trust, London.
Insights
Early treated congenital hypothyroidism can still cause mild hearing and vestibular abnormalities in children. These issues are less severe than previously observed, highlighting the benefits of early intervention.
Area of Science:
- Pediatrics
- Endocrinology
- Audiology
Background:
- Congenital hypothyroidism (CH) requires early treatment to prevent developmental issues.
- The long-term effects of early treated CH on auditory and vestibular systems are not fully understood.
Purpose of the Study:
- To evaluate auditory and vestibular function in children with early treated CH.
- To determine the prevalence and severity of hearing and vestibular abnormalities.
Main Methods:
- Pure tone audiometry, tympanometry, acoustic stapedial reflex thresholds (ASRTs), and auditory evoked brain stem responses (AEBRs) were performed.
- Vestibular function was assessed using electronystagmography, rotational, and caloric tests.
- 38 children aged 10-12 years with early treated CH were included.
Main Results:
- Mild sensorineural hearing loss (>15 dB) was detected in 18 children (47%).
- Abnormalities in vestibular function were found in 12 of 29 tested children (41%).
- A trend suggested more severe abnormalities correlated with more severe hypothyroidism before treatment.
Conclusions:
- Mild auditory abnormalities remain common in early treated CH, though less severe than historically reported.
- Mild vestibular dysfunction may also be prevalent in this population.
- Early treatment significantly mitigates, but does not entirely eliminate, sensory system impacts.
Abstract:
Pure tone audiometry, tympanometry, acoustic stapedial reflex thresholds (ASRTs), and auditory evoked brain stem responses (AEBRs) were carried out in 38 children with early treated congenital hypothyroidism aged 10-12 years, together with tests of vestibular function (electronystagraphy, rotational, and caloric tests). Sensorineural hearing loss with thresholds of greater than 15 dB was detected in 18 children (10 at 8 kHz only); only two children had more than 40 dB hearing loss, each in one ear. Raised ASRTs were found in eight children and two children had abnormal AEBRs. Of the 29 children tested, 12 had an abnormality of vestibular function. Although not significant at the 5% level, there was a tendency for the abnormalities to be more prevalent and severe in the children with more severe hypothyroidism, as judged by pretreatment plasma thyroxine. It is concluded that (i) mild abnormality of hearing is still common in children with congenital hypothyroidism despite early treatment but this is much less severe than that found before neonatal screening and (ii) mild abnormalities of vestibular function may be common in early treated congenital hypothyroidism.

