Clinical and audiological evaluation of hearing impaired children

Abstract

Daily activities, interpersonal relationship, employment, and general well being; among such skills, communication skills are essential to a successful life for all individuals. Such skills affect education, adequate hearing acuity is of paramount importance and acts as a prerequisite in the overall personality development of an individual. Hearing impairment at any age has serious effects on the day to day life of an individual and he/she feels handicapped socially, emotionally, and scholastically. A child stuck with this malady is a back bencher in the class, excommunicative, and absent-minded. This study was conducted in order to find out various causes of hearing impairment in children and to study role of various audiological and radiological tests in finding the cause of impaired hearing in children. Aims and Objectives: To assess the possible etiological causes of hearing impairment in children. Study role of various audiological tests in finding the cause of impaired hearing in children. Study Design: Prospective study. Materials and Methods: This study was conducted in the Department of ENT and HNS of government medical college Srinagar. A total of 150 children of age range 0-14 years visited our ENT Department with complaints of impaired hearing, but only 70 children who met the inclusion criteria of impaired hearing and defective/delayed speech were selected for this study. Results of initial evaluation by means of comprehensive clinical history and followed by proper thorough systemic physical examination from head to toe was performed. These hearing impaired children were subjected to various subjective and objective tests; pure tone audiometry and behavioral observation audiometry were performed for subjective tests and impedance audiometry, Oto-acoustic emissions (OAE), and brainstem evoked response audiometry (BERA) were performed for objective tests. Results: Possible etiological cause on the basis of history were birth anoxia (2.85%), premature (5.71%), low birth weight (4.28%), hyperbilirubinemia (4.28%), and consanguinity (42.86%). Possible cause revealed after proper systemic examination includes 2.85% children with craniofacial abnormalities, 2.85% children with Down's syndrome, and 1.42% with Usher's syndrome. OAE revealed 70% bilateral REFER and 30% bilateral PASS. Impedance audiometric results were mostly Type A tympanogram. Pure tone audiometric results were mostly on profound hearing loss (86.69%). BERA findings were mostly on profound hearing loss (85.79%). Conclusion: In this study large vestibular aqueduct (LVAQ) is most common cause of abnormality detected in hearing impaired children.