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Hearing aid

Hearing aid

Question:

- Today I did my little boy a few ear investigations and he was told that "the cochlear function is affected by 30 decibels" tomorrow to contact the doctor for a discussion regarding the prosthesis of the baby in both ears. I should mention that the little boy underwent surgery at the age of 2 days in the same hospital for the condition "ulcer-necrotic enterocolitis with the appearance of a red leaf" (ie the intestines were necrotic due to the fact that the abdomen was practically full of meconium. The doctors did not find either a crack in the intestines and they came to the unofficial conclusion that he probably took a virus from the nesting room that affected the walls of the intestines and made them "sweat" losing its impermeability) and for more than a month he was not given no chance of survival. Throughout the hospitalization, he was given several blood and plasma transfusions and was treated at one time with 5 antibiotics concomitantly, because after the surgery he entered an advanced state of septicemia. During the hospitalization the doctors discovered a grade 3 systolic blast, which after the treatment at the age of 6 months disappeared completely. I never understood how and under what conditions my little illness contacted at that early age, or what was the cause. However, the doctors considered it a "wonder" because basically they just opened it, not knowing what it was, they disinfected it and washed it with betadine and closed it. A few months ago after I took the child to kindergarten, at the teacher's advice I went with the child to the ophthalmologist where a myopia was noticed and I put on his glasses. All the upper incisors (4) were crushed to the gums, I thought it was probably a lack of calcium. Then, at the teacher's advice, I went with him to the ENT doctor and found out the ones presented above. I mention that the little boy was permanently under medical assistance (visits to the family doctor almost monthly) and I constantly called the doctor's attention to the "special" character of the little boy, the state of agitation, the fact that he was screaming, he slept very little and had nervous . We as parents and grandmother helping to raise him all the time thought about the fact that we could lose him and the premise "no matter what it is to live!" probably nothing seemed serious or suspicious to us after the operation, thinking that probably it was too much, which seemed understandable. Do you think the prosthesis will be permanent? What are the causes of these hearing impairments? Is it possible that all of these dysfunctions occurred as a result of the rather aggressive treatment that was given to her after that surgery?

Answer:


deafness it is not actually a disease, but a symptom corresponding to a different etiology and can be:

  • transmission deafness - the lesion is located at the level of the transmission device (external ear, middle ear and labyrinth windows);
  • deafness nervous reception - the lesion is located in the inner ear, on the retrolabyrinthine nerve pathways or on the root portion of the auditory nerve;
  • mixed type deafness - the lesion also affects both compartments of the peripheral hearing device.
    Causes of transmission deafness
  • external ear lesions, through:
    - malformations,
    - duct stenosis,
    - infections of the external auditory canal,
    - tumor obstructive lesions,
  • middle ear lesions, through:
    - tubular obstruction,
    - otitis media and their sequelae,
    - tumors,
    - ossicular malformations,
  • lesions of the optic capsule, through:
    - infections,
    - otospongiosis.
    Causes of nervous reception deafness
  • internal ear lesions:
    - malformations,
    - drug poisoning,
    - infections,
    - vascular disorders,
    - trauma,
    - tumors,
    - heredity,
  • retrolabyrinth or radicular lesions:
    - bacterial infections (meningitis, petrosite),
    - viral infections (mumps, shingles),
    - neurite,
    - tumors (acoustic neuroma),
  • central lesions - only basebulbar lesions and not superabulbular lesions can produce deafness.

    Hearing loss

    Depending on the value in decibels HL of the tonal loss, the hearing loss are classified in:
    Easy hearing loss: 21-40 dBHL The normal conversation is heard, but the whispered voice is not understood correctly.
    Average hearing loss: 41-70 dBHL The voice of conversation is not heard, the patient only hears the shouted voice and does the labiolectura.
    Severe hearing loss: 71-90 dBHL The patient partially hears the shouted voice, the labiolectura being very important.
    Deep hearing loss: 91-119 dBHL In the child who does not know how to speak, he produces surdomitude. The hearing aids allow the application of a prosthesis.
    Cofoza: greater loss 120 dBHL
    The diagnosis of deafness in children consists of establishing the clinical diagnosis of deafness, followed by performing a topodiagnosis of deafness to determine the location of the lesion.
    The treatment aims, on the one hand, to combat by specific means the etiological agent (the cause) and, on the other hand, the re-education of the child, in the sense of winning or maintaining the language.
    Re-education is differentiated, as practiced in very young children, before the age of 2-3 years (prelabic phase) or after the age of language acquisition (post-lab phase).
    The surgeon O.R.L., the speech therapist and the orthophonist, deal with the problem of deaf children.
    Hearing plays a particularly important role in language acquisition, cognitive property development and socio-affective development. The deterioration of the hearing function can be based on many reasons. In cases where the diseases of the auditory analyzer cannot be treated by the medicinal or surgical means, prosthetic solutions are used. In choosing the prosthesis, the following data regarding hearing loss will be taken into account:
  • installation mode: suddenly / gradually,
  • installation age: it is an important element for choosing the prosthetic gain reserve,
  • evolution: acute or chronic, progressive or fluctuating,
  • installation: sudden or gradual,
  • character: temporary or permanent,
  • mode of affectation: unilateral or bilateral.

    Types of hearing aids


    Depending on their shape, hearing aids are classified into:
  • Intra-ear - Conca (ITE) These prostheses are worn in the external auditory canal and basin. They are mounted in individual housings and adjusted according to the degree of hearing loss.
  • Intra-earphone - Channel (ITC) The prosthesis is also individualized, occupying the entire external auditory canal. Due to its small size, it is less visible.
  • Intra-earphones - Complete in the canal (CIC) This model of hearing aid is the smallest and newest. The housings are individualized, so they are almost invisible to the ear.
  • Retro-earphones (BTE) Hearing aids have an elongated shape and are worn behind the ear. A small elbow follows the line of the ear, making the connection with the olive.
    Inside each prosthesis, there is a microphone, which captures the sound, which is then amplified and transmitted further into the ear. Olive is the piece that anchors the prosthesis in the ear. It is made after ear molding and also has the role of guiding the sound.
    Back-to-back prostheses are always recommended for children, being easy to wear and adjust to the growing child's ear.
    From the ones you can tell, I can only conclude that your boy has one mild bilateral hearing loss. The possibility that this suffering is caused by aggressive postoperative treatment, ie antibiotic, can only be discussed if we know what antibiotics were given and how long (those with increased ototoxicity, such as gentamicin, for example).
    Regarding the causes of this dysfunction and if the prosthesis is definitive, the only person able to answer you is the doctor O.R.L. who consulted the child and knows exactly what it is about. I have tried to present some general informative data to help you understand the suffering of your child and the treatment you should follow. Good health and I expect you if you have new concerns.
    Dr. Dana Paduraru,
    Specialist in pediatric surgery
    Emergency Clinic Hospital for Children "Grigore Alexandrescu"
    Specialist details