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Suggest Treatment For Moderate Hearing Loss In Right Ear Of A 2 Year Old

Posted on Wed, 15 Apr 2015

Question: Is there an ENT expert out there?

My daughter is 2 1/2 years old and we have known for year or so that she has a moderate/severe hearing loss in her right ear. We know that the loss isn't caused by glue ear (except sometimes she also has fluid in her ear which makes her hearing even worse), but we don't know what is causing it. The hearing in her left ear is 'borderline normal'. Until now we have just monitored her hearing with regular tests, as she seems to be able to hear fine at home and her speech is developing normally. She started pre-school in January, however, and the teachers have noticed that she often cannot hear them if they are on her right hand side or behind her. They then have to tap her on the shoulder or get in front of her to get her attention. She then appears to hear them fine, as long as they stay in front of her and down at her level. There is obviously a lot more background noise at pre-school than there is at home.

I am wondering if a hearing aid would be helpful at this stage, to help her hear better at pre-school? What are the pros and cons of fitting a hearing aid on a 2 year old with a unilateral hearing loss? What questions should I be asking the audiologist when we go for her routine hearing test in a few weeks time?

Any comments would be really appreciated. Thanks in advance!

Answered by Dr. Naveen Kumar Nanjasetty (1 hour later)

Brief Answer:
Hearing aid is required for the affected ear...

Detailed Answer:
Hi

Thanks for posting the query. I have gone through the query thoroughly and understood the problem. I'll try my best to help you with this.

1. Yes, she would require a hearing aid, to augment the sounds.

2. Fitting a hearing aid will actually improve the cognitive skills of the child. The goal is for your child to be able to hear and understand speech in the ear with hearing loss. It may also allow your child to have a perception of more "balanced" hearing. The common problems encountered are, the child may either lose the instrument or damage it.

3. Request your audiologist for a complete audiological evaluation including BERA (brain evoked response audiometry). He would be the better person to guide you.

4. Get the hearing evaluated once in six months. This is to check for any worsening in the hearing, if so, then a MRI of the brain may be required.

Hope I have answered your query; I'll be available for the follow up queries.

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Naveen Kumar Nanjasetty (37 minutes later)

Your reply is very helpful - many thanks!

I have two more quick questions.
- Would she need to wear the hearing aid the whole time, or just in environments where there is lots of background noise and she struggles to hear?
- Am I right in thinking that the younger the child is when they start wearing a hearing aid, the better their brain adapts to suddenly receiving more information from the damaged ear? If so, is she still young enough at 2 1/2 years that we can 'optimise' her brain's ability to benefit from a hearing aid?

Hopefully these are my last questions. Thanks again!

Answered by Dr. Naveen Kumar Nanjasetty (15 minutes later)

Brief Answer:
Neural plasticity will be better in younger kids..

Detailed Answer:
Hi

Thanks for writing back

1. Yes, she needs to wear the hearing aid all the time, except before sleep and shower.

2. You are right, the younger the child starts listening, the better will be the understanding skills of the child. This is called 'neural plasticity' and the child's brain is compared to that of 'wet cement'. The neural plasticity is lost as the child grows older. Fortunately, your daughter is still very young, she will definitely improve with early intervention.

3. Please feel free to ask any number of questions. I'll be eager to help you out.

My best wishes for the little XXXXXXX God bless her.

Regards
Dr. Naveen Kumar N
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Raju A.T