Consultation with the Specialist
Hearing Loss in the Absence of Otitis Media
John F. Kveton MD1
1 Department of Otolaryngology, Yale University School of Medicine, New Haven, CT.
Otitis media is the most common infectious disease seen in the pediatric population. Hearing loss is a well-recognized sequela of otitis media, whether acute or chronic. In acute cases, hearing generally returns as the resulting effusion resolves, which may take up to several months. Hearing loss in chronic otitis media often resolves during quiescent stages of the disease; persistent hearing loss that fails medical management is best treated through surgical intervention. Tympanosotomy tube insertion effectively recovers hearing in cases of chronic middle ear effusions, whereas tympanoplasty and ossiculoplasty, often in conjunction with mastoidectomy, are necessary for chronic draining ears. Hearing loss may occur in the absence of otitis media. In such cases the clinician must be aware of the potential ramifications of the hearing loss for the child as well as the proper method of evaluating such a patient.
Background
During the first 5 years of childhood, the ability to hear is related intimately to the degree of speech and language acquisition as well as to the development of emotional, social, and academic skills. It is estimated that a normal-hearing 5-year-old child has a vocabulary of 5000 to 26 000 words, whereas a profoundly hearing-impaired child has a vocabulary of 200 words. The effects on reading ability are equally astounding, with the average reading achievement for hearing-impaired 16-year-olds at the third- or fourth-grade level.
