Pediatric Hearing Loss Research Articles

Knowledge, attitudes, and practices of gynaecologists and paediatricians regarding newborn hearing screening in Odisha

Background: Gynaecologists and paediatricians are crucial in detecting hearing loss at the first level of intervention. These healthcare workers are the ones who initially interact with infants and their parents. Therefore, they must understand the risk factors for newborn hearing loss and have a positive attitude toward early intervention. There were few studies conducted to evaluate the Knowledge Attitude and Practices (KAP) of New Born Hearing Screening (NBHS) among paediatricians and other physicians in Western countries and few in the Indian context. Thus, the current study aims to compare and examine the knowledge, attitudes, and practices of gynaecologists and paediatricians regarding newborn hearing screening in Odisha. Methods: A survey questionnaire containing 45 close-ended and 5 open-ended questions was developed. This questionnaire was validated by paediatricians, gynaecologists, and audiologists and then applied among 300 professionals in Odisha. Results: In all the sections it was found that paediatricians have greater knowledge than gynaecologists, however, both professionals have a positive attitude towards NBHS in Odisha. Mann-Whitney U test revealed significant differences in knowledge, attitudes, and practices among paediatricians and gynaecologists in Odisha. Conclusions: From this survey, it can be concluded that most of the paediatricians know more about paediatric hearing loss in comparison to gynaecologists, while both of them have positive attitude in implementing NBHS in Odisha. An awareness should be created among both the professionals about NBHS, effect of hearing loss and to whom they can refer for NBHS, which will benefit the newborns and their parents.

Cochlear Implantation in Pediatric Cochlear Nerve Deficiency: A Systematic Review and Meta-Analysis.

Cochlear nerve deficiency (CND) is commonly implicated in moderate-to-profound pediatric sensorineural hearing loss (SNHL). Although cochlear implantation (CI) was previously contraindicated in CND patients, recent studies have demonstrated the potential for auditory response to CI in a subset of CND patients, though clinical outcomes remain variable. This study aims to evaluate pre- and postoperative speech and auditory outcomes of CI in pediatric patients with bilateral SNHL and radiographically confirmed CND. Embase and Ovid MEDLINE. A systematic review was conducted to identify studies reporting pre- and postoperative outcomes of children with CND confirmed by magnetic resonance imaging who underwent CI. A random-effects model was used to account for within- and between-study variance in speech and auditory outcomes. After abstract screening of 818 distinct articles, 16 studies were selected for final inclusion, consisting of 248 patients with cochlear nerve hypoplasia or aplasia who underwent CI. Various speech perception and language development tests were investigated across studies (Speech Intelligibility Rating, Speech Perception Category, Speech Awareness Thresholds, Meaningful Auditory Integration Scale, Meaningful Use of Speech Scale, Categories of Auditory Performance, and Auditory Level). Pooled outcomes demonstrated improvement in speech perception after CI in pediatric patients with CND (SMD 2.18, 95% CI 1.68-2.69). Indications for CI are expanding as research demonstrates benefit in populations previously thought inappropriate. Our study demonstrates global postoperative improvement in speech and auditory outcomes in children with bilateral SNHL and CND after CI. NA Laryngoscope, 2024.

Parent experiences with genetic testing for pediatric hearing loss.

The purpose of the current study was to assess parent perceptions and experiences of genetic testing, as well as barriers for not undergoing testing in a sample of families of children with hearing loss. A 44-item questionnaire, The Parent Perception of Genetic Testing Questionnaire developed by the research study team was administered. Participants were recruited from a pediatric otolaryngology/audiology practice and social media. A total of 146 parents of children with hearing loss participated. Approximately 47.6% of the children in our sample underwent genetic testing, 44.8% did not, and 7.6% of parents were unsure. For those that did not undergo testing, reasons included: unaware (6.2%), not interested (8.9%), cost (8.9%), time (3.4%), fearful of results (2.7%), and never offered (15.1%). For those that did undergo testing, over half of the parents reported that they did not receive counseling before (55.1%) and 41.7% reported they received counseling after the testing. Furthermore, parents were confused about the results with 18.3% reporting they were Very Confused, 28.3% Somewhat Confused, 20% A Little Confused, and 33.3% Not Confused at All about the variant of uncertain or unknown significance. Notably, less than half of parents (43.4%) remembered what they were told about the mode of inheritance. Overall, our study highlighted the low adoption rate of genetic testing and lack of integration into standard of care for otology/audiology practices. Collaboration between hearing healthcare professionals and geneticists is warranted to determine how to reduce barriers to access while improving pre- and post-counseling.

Genetic testing for pediatric sensorineural hearing loss in the era of gene therapy.

To summarize indications, methods, and diagnostic yields for genetic testing for pediatric hearing loss. Genetic testing has become a cornerstone of clinical care for children with sensorineural hearing loss. Recent studies have shown the efficacy of gene panels and exome sequencing for any child with sensorineural hearing loss. Recent findings have underscored the importance of a diagnosis in clinical care. Clinical trials for gene therapy for hearing loss have begun. Genetic testing has become critical for personalized care for children with hearing loss. Recent studies have shown a 43% overall diagnostic yield for genetic testing for pediatric hearing loss, though the diagnostic yield may range from 10 to 60% depending on clinical features. Syndromic diagnoses comprise 25% of positive genetic tests for pediatric sensorineural hearing loss. While diagnostic yield is lower for children with unilateral or asymmetric sensorineural hearing loss, the likelihood of syndromic hearing loss finding is higher. An early and accurate genetic diagnosis is required for participating in clinical trials for gene therapy for hearing loss.

Deciphering the mechanisms of the IL-6/CXCL1 and NOD-like receptor signaling pathways in otitis media with effusion in rodents

BackgroundOtitis media with effusion (OME) often leads to pediatric hearing loss and is influenced by innate and adaptive immune responses. Innate immunity serves as the non-specific first line of defense against OME. MethodsWe induced OME in rats using ovalbumin. We administered IL-6 monoclonal antibodies intranasally to inhibit IL-6, and we injected an NF-κB inhibitor intraperitoneally to explore the role of IL-6 in innate immunity and its interaction with the NOD-like receptor signaling pathway. We analyzed RNA-sequencing data with Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathways to assess signaling pathways involved in OME. We also utilized Western blot, quantitative real-time PCR, and immunohistochemistry on middle ear samples and used microscopy to identify immune cells in ear wash fluids. ResultsOur study suggests a pivotal role for IL-6 in the immune pathways of rats with OME via the regulation of CXCL1-mediated pathways. Increased levels of IL-6 and CXCL1 were observed in the middle ear tissues, and activation of the NLRP3 inflammasome in OME rats led to an immune response via NF-κB, thus promoting IL-6 and CXCL1 production, which was reduced by IL-6 antibody treatment. ConclusionsOur findings confirm that IL-6 and CXCL1 play significant roles in the innate immune response in OME in rodents, predominantly via the NOD-like receptor signaling pathway and NLRP3 inflammasome activation. This research sheds light on OME pathogenesis and its immune-related mechanisms.

Audio-Vestibular Evaluation of Pediatric Pseudo-Conductive Hearing Loss: Third Window Syndromes.

Conductive hearing loss caused by external or middle ear problems prevents the transmission of sound waves from the external auditory canal to the cochlea, and it is a common condition, especially in pediatric patients aged 1-5 years. The most common etiological factors are otitis media and cerumen during childhood. In some patients, external and middle ear functions and structures may be normal bilaterally despite the air-bone gap on the audiogram. This condition, which is often a missed diagnosis in children, is defined as a pseudo-conductive hearing loss (PCHL) caused by third window syndromes (TWSs) such as semicircular canal dehiscence, inner ear malformations with third window effect, and perilymphatic fistula. In this review of the literature, the authors emphasize the pitfalls of pediatric audio-vestibular evaluation on TWSs as well as the key aspects of this evaluation for the differential diagnosis of PCHL brought on by TWSs. This literature review will provide audiologists and otologists with early diagnostic guidance for TWSs in pediatric patients.

Socioeconomic Disparities and Other Factors Affecting Time to Dispensing of Pediatric Hearing Aids.

Pediatric hearing loss can significantly impact speech, language, social, and educational development. Providing access to speech and environmental sounds using amplification devices, such as hearing aids, can help improve developmental outcomes. However, timely rehabilitation and intervention may be delayed due to limited access to resources, further prolonging the adverse effects of childhood hearing loss. The aim of this study was to investigate socioeconomic barriers in time to dispensing hearing aids in a diverse pediatric patient population. Data from an existing internal database from a tertiary pediatric hospital were analyzed from January 2020 through August 2022 for barriers associated with hearing aid (HA) dispensing delays. Demographic and clinical characteristics were obtained. Multivariate regression and survival analysis statistics were used to identify factors associated with delayed time to dispensing hearing aids. Of the 121 patients who had been appropriately diagnosed and fit, 108 (89.3%) had received hearings aids and 13 (10.7%) had not at the time of the study. Of those who had received HA, time to dispensing was not significantly impacted by sex, race, ethnicity, language, or income level. Insurance was found to be an influencing factor in time to receiving the HA. Factors such as insurance and hearing loss laterality contribute to delays in receiving hearing aids. Identifying these specific barriers and disparities in hearing rehabilitation services will prove vital in facilitating an expedited and equitable pathway to receiving hearing aids. 3 Laryngoscope, 2024.

Understanding pediatric inpatient conductive hearing loss: An analysis of patient demographics

ObjectiveHearing loss is a common sensory impairment in children that affects quality of life and development. Early intervention, such as hearing aids and communication therapies, can help children overcome these challenges and lessen the impact on their development. The objective of this study was to identify specific patient demographic factors correlated with the prevalence of pediatric conductive hearing loss. Study designThe study utilized the Kids' Inpatient Database (KID) by the Agency for Healthcare Research and Quality which collects inpatient information from hospitals for patients under 21 years old. We included all patients discharged in 2016 diagnosed with conductive hearing loss, and excluded neonatal patients discharged within 28 days of birth. MethodsStatistical analyses were performed using R Studio and IBM SPSS Statistics. Weighted odds ratios were calculated for conductive hearing loss in relation to race and income, and a multivariate regression analysis examined associations between demographic variables and race categories in conductive hearing loss. ResultsThe prevalence of conductive hearing loss (CHL) in pediatric patients in 2016 was 51.62 cases per 100,000 patients. Non-Hispanic White patients had the highest prevalence, while Black patients had the highest likelihood of CHL compared to the overall population. Lower income levels were associated with a decreased probability of CHL diagnosis. After adjusting for age, sex, hospital region, insurance, and income on multivariate analysis, White and Black patients were less likely to be diagnosed with CHL. Furthermore, patients in specific income quartiles also had lower CHL likelihood compared to the general population. ConclusionWhile Black patients had a higher likelihood of being diagnosed with CHL than the general population, socioeconomic factors such as income greatly influenced the likelihood of CHL diagnosis. Other significant factors included income, region of the country, sex, and age. Further research is needed to better understand and address healthcare disparities related to pediatric hearing loss.

Listening to the Past, Predicting the Future: A Bibliometric Exploration of Hearing Loss Publications Over Four Decades.

This article aims to analyze the scientific literature on hearing loss (HL) in the field of Otorhinolaryngology published from the past to the present. A comprehensive dataset comprising 8013 articles on HL, spanning from 1980 to 2023, was retrieved from the Web of Science database and analyzed using various statistical and bibliometric methods. The leading countries in productivity were the United States, Japan, and Germany. The top productive journals included the International Journal of Pediatric Otorhinolaryngology (n = 652), Otology & Neurotology (579), and Acta Oto-Laryngologica (512). The journals with the highest h-index on hearing loss were Hearing Research (h = 65), Ear and Hearing (60), and Laryngoscope (55). Factor analysis revealed that the HL literature consisted of four constructs: main topics, speech/sound, genetics, and pharmaceutical therapies. Sudden sensorineural HL, sensorineural HL, cochlear implant, unilateral, noise-induced and conductive HL, pediatric and age-related HL, tinnitus, auditory brainstem response, audiometry, and prognoses for hearing health were the most researched topics from past to present. In recent years, the trending topics are genomic analysis, gene mutations, whole-exome sequencing, genetic sequencing technique, the use of machine learning in HL, and the effect of COVID-19 on hearing health. The bibliometric analysis results clearly indicate significant progress in the field of hearing loss over the past 40 years. The 8013 articles published between 1980 and 2023 encompass a wide range of research in this area. These analyses can assist in identifying priority areas and focal points for future research. NA Laryngoscope, 134:4697-4706, 2024.

Pediatric Hearing Loss and the Multidisciplinary Approach. The Hearing Disability Team (HDT) Experience

Hearing loss is among the utmost common disorders in children and a late diagnosis can impact language and cognitive development. With the aim of implementing an early hearing detection program (EHDP), the Emilia Romagna region has officially approved, since 2012, a NHS program distinguishing well babies and NICU children. Aim of this study is to evaluate the results of the application of these regional guidelines through data flow from the Child and Adolescent Mental Health Services (CAMHS). Data of children born between 2012 and 2018 and admitted to the service in the same period were collected, 84 children (56 males,28 females) were enrolled; 65% of the children were taken in charge by CAMHS within the first year of life. Concerning the NHS results, 77 (91%) children resulted fail at the screening test (6 unilateral fails), while the result was not available in one case; 6 children resulted pass. Most cases, 79 (94%), presented bilateral hearing loss. In particular, 14 (17.8%) children had a profound hearing loss, 10 (12.6%) a severe hearing loss, 10 (12.6%) a mild hearing loss (6 were conductive), 22 (27.8%) a moderate hearing loss, and 23 (29.2%) a moderate/severe hearing loss. Finally, 5 resulted affected by unilateral hearing loss (2 profound hearing loss, 3 severe). This study confirmed that regional recommendations about early diagnosis of hearing loss have been applied and most children accessed the CAMHS timely. To this aim synergism between hospital and territorial services, determining the implementation of the organization system was the keystone.

Early assessment of communicative competence in children with hearing loss using the Child-Caregiver Communication Assessment through Rebesco's Evaluation (CC-CARE) method

PurposeThis work presents a new frame-by-frame video analysis method called Child-Caregiver Communication Assessment through Rebesco's Evaluation (CC-CARE), developed in the context of pediatric hearing loss as a rehabilitation tool for assessing children's early communication skills. CC-CARE stems from the commonly used Tait video analysis and extends it by including a new set of parameters aimed at disentangling between hearing-dependent and hearing-independent aspects of communication. Method: In this paper, we collected video samples of child-caregiver interactions in a group of 65 normal-hearing children and a group of 165 hearing-impaired children. For each group, we present the CC-CARE method and describe the parameters, their score distributions, correlations and we estimate the adherence of the CC-CARE scores with children's developmental trajectory. Moreover, we compare the results of CC-CARE scores between the two groups having had different development of the auditory system. Finally, a fully-data driven approach was employed to assess the consistency of the communicative efficacy index (CEI), a score aiming to capture a global result of the CC-CARE procedure. Results: Correlations among parameter scores were found in each within-group analysis, revealing CC-CARE's internal consistency in measuring associated but nonoverlapping communication dimensions. For both groups, CC-CARE scores were associated with participants' age. Differences between scores emerged for a between-group analysis, indicating CC-CARE sensitivity to extract communication differences as a function of the hearing status. For both groups, the data analysis revealed that the CEI captures large variance portions across all parameter scores of the CC-CARE method. Conclusions: Results provide the first evidence that the CC-CARE video analysis method could be a reliable tool capable of highlighting the cascading effects of hearing impairment on children's preverbal communicative efficacy. The CC-CARE method aims to support early rehabilitation of hearing loss by describing a child's communicative efficacy.

Bioinformatics characterization of variants of uncertain significance in pediatric sensorineural hearing loss.

Rapid advancements in Next Generation Sequencing (NGS) and bioinformatics tools have allowed physicians to obtain genetic testing results in a more rapid, cost-effective, and comprehensive manner than ever before. Around 50% of pediatric sensorineural hearing loss (SNHL) cases are due to a genetic etiology, thus physicians regularly utilize targeted sequencing panels that identify variants in genes related to SNHL. These panels allow for early detection of pathogenic variants which allows physicians to provide anticipatory guidance to families. Molecular testing does not always reveal a clear etiology due to the presence of multigenic variants with varying classifications, including the presence of Variants of Uncertain Significance (VUS). This study aims to perform a preliminary bioinformatics characterization of patients with variants associated with Type II Usher Syndrome in the presence of other multigenic variants. We also provide an interpretation algorithm for physicians reviewing molecular results with medical geneticists. Review of records for multigenic and/or VUS results identified several potential subjects of interest. For the purposes of this study, two ADGRV1 compound heterozygotes met inclusion criteria. Sequencing, data processing, and variant calling (the process by which variants are identified from sequence data) was performed at Invitae (San Francisco CA). The preliminary analysis followed the recommendations outlined by the American College of Medical Genetics and Association for Molecular Pathology (ACMG-AMP) in 2015 and 2019. The present study utilizes computational analysis, predictive data, and population data as well as clinical information from chart review and publicly available information in the ClinVar database. Two subjects were identified as compound heterozygotes for variants in the gene ADGRV1. Subject 1's variants were predicted as deleterious, while Subject 2's variants were predicted as non-deleterious. These results were based on known information of the variants from ClinVar, multiple lines of computational data, population databases, as well as the clinical presentation. Early molecular diagnosis through NGS is ideal, as families are then able to access a wide range of resources that will ultimately support the child as their condition progresses. We recommend that physicians build strong relationships with medical geneticists and carefully review their interpretation before making recommendations to families, particularly when addressing the VUS. Reclassification efforts of VUS are supported by studies like ours that provide evidence of pathogenic or benign effects of variants.

Cognitive and language outcomes for pediatric hearing loss with otologic surgery

ObjectivesTo test the hypothesis that surgical otologic intervention for any type of pediatric hearing loss decreases the odds for incident adverse cognitive and linguistic developmental outcomes. Study designRetrospective cohort database study. MethodsElectronic medical record data from the TriNetX Research Network were queried for children with congenital, sensorineural, conductive, and mixed hearing loss (HL) between ages 0 and 5 years. Patients were further stratified by presence (HL + surgery) or absence (HL-surgery) of surgical intervention at any point following diagnosis, including cochlear implantation, tympanoplasty with or without mastoidectomy, and tympanostomy. Primary outcomes were defined as odds for new adverse cognitive or linguistic outcomes at any point given HL treatment status [odds ratio with 95% confidence interval, (OR; 95%CI, p-value)]. Cohorts were balanced using propensity-score matching (PSM) based on US census-defined demographics and clinically relevant congenital conditions. ResultsOf 457,636 total patients included in the study, 118,576 underwent surgery (HL + surgery cohort) and 339,060 did not (HL-surgery). In matched cohorts, surgical otologic intervention significantly decreased the odds of developing cognitive disorders including scholastic, motor, psychological developmental disorders, and pervasive developmental delays (p < 0.01). ConclusionsSurgical interventions for treatment of pediatric HL including cochlear implantation, tympanoplasty with or without mastoidectomy, and tympanostomy should be considered as they may prevent delays in development.

Cochlear Implantation Outcomes in Pediatric Unilateral Hearing Loss: Impact of Device Use and Direct Input.

To investigate the impact of daily cochlear implant (CI) use on speech perception outcomes among children with unilateral hearing loss (UHL). Multi-institutional retrospective case series of pediatric patients with UHL who underwent CI between 2018 to 2022. Three tertiary children's hospitals. Demographics were obtained including duration of deafness and age at CI. Best consonant-nucleus-consonant (CNC) word scores and data logs describing hours of CI usage were assessed postimplantation. Use of direct audio input (DAI) during rehabilitation was recorded. Twenty-seven children were included, with a mean age at CI of 7.8 years. Mean datalogging time was 7.8 ± 3.0 hours/day. 40.7% of children utilized daily DAI. The mean CNC score using the best score during the study period was 34.9%. There was no significant correlation between hours of CI usage and CNC score. There was a significant improvement in CNC score associated with whether the child used DAI during rehabilitation (CNC 50.91% [yes] vs 23.81% [no]), which remained significant when adjusting for age at CI, duration of deafness, and data log hours. Unlike children with bilateral hearing loss and CI, children with UHL and CI demonstrate no significant correlation between hours of daily CI usage and CNC scores. However, children who used DAI during postoperative rehabilitation achieved significantly higher CNC scores than those who did not. This suggests that rehabilitation focused on isolated listening with the implanted ear maybe critical in optimizing outcomes with CI in UHL patients.

Management of pediatric sensory neural hearing loss: a case report

Abstract Early childhood is the age of learning and experiencing various things through hearing or seeing. Any abnormality in hearing in this age group makes the child dull and self-isolating, affecting his morale. This is a case of an 8-year-old boy with deficient hearing from both ears, which was left unnoticed until the age of 5 years. There is no similar family history. The antenatal and neonatal history was found to be normal, but the child used to get fever and upper respiratory tract infection very frequently. The patient was taken for an otorhinology consultation after being noticed nonresponsive to moderately loud sounds and calls from behind. Otologic investigations—brain-evoked response audiometry and distortion product otoacoustic emissions—revealed bilateral mild-to-moderate hearing loss. Ayurveda treatment was given with 8 months of follow-up, and investigations were recorded. The aim of this report was to analyze a case of sensorineural hearing loss (SNHL) in a pediatric age group and its management through Ayurveda. The site of this study was the National Institute of Ayurveda Hospital, Jaipur, and this is a single-case report. All the relevant history was taken, followed by the investigations required for the case. Since the patient was a minor, consent was obtained from his father for the publication of this case report. For the conceptual part, various textbooks and research papers on Ayurveda and allopathy available online and offline were referred to. The patient was advised to go for speech therapy along with the Ayurvedic treatment Karnapoorana and other oral formulations. After 8 months of follow-up, this patient was found to be more responsive with improved hearing and general immunity.

Pediatric sensorineural hearing loss related COVID-19. Clinical cases

To present clinical cases of sensorineural hearing loss in children under 5 years of age after a novel coronavirus infection. We report 3 cases of unilateral and 1 case of bilateral acquired deep sensorineural hearing loss, while the association with SARS-CoV-2 has been confirmed anamnetically and/or laboratory. The SARS-CoV-2 virus can have a depressing effect on the cochlea on its own or enhance the toxic effect of viruses during the recovery period after COVID-19. The true frequency of acute sensorineural hearing loss of infectious origin in childhood and, as its outcome, the formation of persistent hearing impairment has not been determined. Viruses are volatile, contagious, and clinically dangerous due to their complications. Vaccination is the most effective measure for the prevention of infectious diseases.

Genetics evaluation outcomes of patients with pediatric hearing loss: 2008–2022 retrospective study

ObjectiveThis study aims to explore how genetics evaluation and testing for patients with pediatric onset hearing loss affects their diagnosis and management. MethodsRetrospective chart review was completed for patients with pediatric hearing loss that were evaluated by a genetic counselor from 2008 to 2022 with data entry into a REDCap database. Descriptive statistical analysis was completed. ResultsFour hundred twenty-nine patients with pediatric onset hearing loss were evaluated by genetics. Majority of patients presented with bilateral (67 %) and sensorineural (83 %) hearing loss. Genetic testing was recommended for 76 % of patients with pediatric hearing loss evaluated by a genetic counselor with 70 % completing some or all recommended tests. Overall genetic testing diagnostic rate was 34 %, with 41 % of diagnoses syndromic. Yearly trends noted an increasing number of patients evaluated, tests ordered, and subsequently an increased number of diagnoses overtime. For diagnostic results, management recommendations were made for 45 % of patients (35/78) and for 92 % of family members (72/78). This compared to total management recommendations for all patients (82/429, 19 %) and family members (110/429, 26 %). ConclusionThis study identified a genetic testing diagnostic rate for pediatric hearing loss of 34 % over 14 years. This study notes the beneficial outcomes of patients with hearing loss and their families meeting with a genetic counselor and the importance of collaboration with hearing loss management colleagues. It highlights the value a genetic counselor consult can add to a patient's diagnostic journey, in addition to how genetic testing impacts management for patients and their families.

Explaining neurological factors of hearing loss through digital technologies

The study investigated how inclusion of the considerable amount of knowledge generated through basic research in multisensory experiences can be brought into clinical paediatric audiology with a specific focus to enhance understanding of the neurological implications of childhood hearing loss. ObjectivesThe overall aim of the project was to investigate how to use emerging technologies to enhance the understanding of the neurological impact of paediatric hearing loss. The specific objectives were to develop an app and to evaluate its ease of use and the understanding of neurology by all types of stakeholders and end-users. MethodsA collaborative participatory and human centred research design was used. This methodological approach brought stakeholders into the design process at an early point of time and workshops mapped the content and interaction of the iterative development of the app. Nine clinicians from Copenhagen Hearing and Balance Centre and 4 media technologists from Multisensory Experience Lab participated in the development of the app-prototype. Evaluations were made by use of questionnaires completed by stakeholders and end-users and focus group interviews. Eight parents with children with hearing loss, 13 internal stakeholders and 14 external stakeholders participated in the evaluation of the app. ResultsThe app was overall positively evaluated. End users/parents with children with hearing loss were slightly more positive than stakeholders/professionals in audiology. ConclusionsApps are a future media for providing health care information and it proved both relevant and applicable to start using apps also to provide complex information such as neurological implications of childhood hearing loss.

Prevalence, Etiology, and Impact of Hearing Loss in Pediatric Populations: A Multicenter Study in Rural Sub-Saharan Africa

This multicenter study delves into the prevalence, etiology, and impact of hearing loss among pediatric populations in rural Sub-Saharan Africa over recent decades. Drawing on a diverse array of healthcare facilities, the research incorporates a comprehensive methodology, including diagnostic tools, genetic testing, and interviews, to unravel the complexities of this often-overlooked health concern. The findings reveal a substantial prevalence of pediatric hearing loss, with infants and toddlers being particularly vulnerable. Genetic factors, infectious diseases, and environmental influences emerge as significant contributors, underlining the intricate interplay of genetic predispositions and external factors. The impact of hearing loss on affected children is profound, affecting psychosocial, educational, and developmental domains. The study emphasizes the urgent need for targeted interventions, early detection, and community-based support services. This research not only advances our understanding of pediatric hearing loss in rural Sub-Saharan Africa but also advocates for the development of context-specific interventions to improve the lives of affected children and their families.

Postmeningitic pediatric hearing loss from non-type b Haemophilus influenzae

BackgroundPostmeningitic hearing loss from Haemophilus influenzae (H. influenzae) is increasingly due to encapsulated serotypes other than type b (Hib) and nontypeable strains (collectively, nHiB H. influenzae). Pediatric hearing loss after nHib H. influenzae meningitis remains poorly described. MethodsRetrospecive case series of nHiB H. influenzae meningitis cases identified from a microbiologic database at Children's Hospital Colorado from 2000 to 2020. Literature regarding nHiB H. influenzae and H. influenzae postmeningitic hearing loss was also reviewed. ResultsEleven cases of nHib H. influenzae meningitis (median age 15.9 months) were identified due to serotype f (36 %), serotype a (27 %), and nontypable strains (36 %). Seven (64 %) patients were male, 55 % were white and 18 % were Hispanic or Latino. Hearing loss was initially identified in 4 children (40 %), with two patients with moderate conductive hearing loss (CHL) and one child with unilateral moderate sensorineural (SNHL) hearing loss patients recovering normal hearing. One patient with bilateral profound sensorineural hearing loss and associated labyrinthitis ossificans required cochlear implantation. All children (4) with identified hearing loss were noted to have additional intracranial sequelae, which included empyema (2), sinus thrombosis (2), and seizures (2). Of patients receiving steroids, 25 % had hearing loss on initial testing, compared to 66 % of those who did not receive steroids. ConclusionsnHib H. influenzae can cause both transient and permanent postmeningitic hearing loss. Steroids may offer otoprotection in nHib H. influenzae meningitis similar to Hib meningitis. Given the limited literature, further study is needed to better characterize hearing outcomes after nHib H. influenzae meningitis.