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Daughter that cannot hear?

Discussion in 'Otolaryngology' started by dobonedoc, Dec 14, 2005.

  1. dobonedoc

    dobonedoc Senior Member
    7+ Year Member

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    I need some help . . .

    I'm much more versed in Ortho issues (PGY III Ortho res) than ENT issues, and now I am facing an issue with my daughter.

    She is almost 5 months old, healthy birth, no history of infections or medications. No complications during prenatal development. She passed her hearing exam in the nursery on her second day of life.

    My wife and I had noticed that she has not been reacting to our voices. I'm not sure when this started, but by this time I expected that she would turn to sounds or startle to a loud noise. So - took her to the ped's office. A hearing test was done in the office, which she failed. Also, she would not turn, or flinch, or do anything when a bell was rung beside her ears as the doc stood behind her.

    No family history of hearing loss. Again, she seems to be normal in every other way. She saw an otologist today, who looked into her ears, said they looked clear, and scheduled her for a hearing exam under sedation later this month.

    Any ideas? I'm trying to stay optimistic that this is some type of correctable problem, but when it is your own child, reason has a hard time getting heard, as the irrational voices of concern wail away in the mind.
     
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  3. willi113

    willi113 Junior Member
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    Have you been to see an audiologist? Also did they tell you why or what kind of hearing test that she failed ?
     
  4. neutropeniaboy

    neutropeniaboy Blasted ENT Attending
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    Hey, man. Any resolution yet?

    I'm trying to piece together a couple of things. PMHx/OBHx doesn't seem to be an issue. I'm assuming there are no craniofacial abnormalities.

    She passed what are called otoacoustic emissions. A simple test for the presence of a functioning cochlea. If she "passed," she didn't have an effusion or an major middle ear problem at the time. It also indicates that her cochlea was responding to the clicks ("talking back") to the machine. OAEs can be pretty tempermental as well. Middle ear effusions will make kids "fail." Too much noise could be interpreted as "fail" (although I suspect that if this was done recently and there was truly too much noise, the audiologist would have commented on that). If they didn't do OAEs and tried to do some visual reinforcement audiology, she may be just on the cusp of what someone her age can do reliably. There are other forms of hearing tests for someone 5-6 months of age. Still, there is a margin of error.

    You said she had a hearing test in her peds office, not her ENT office; so that makes me wonder even more.

    This issue of the hearing test under sedation may be an ABR (auditory brainstem response) where they will check the auditory pathway from the cochlea to the auditory complex. It's not necessarily a hearing test, rather a test to ascertain whether the hardware is intact from the cochlea on up. If the signal gets delayed before the cochlea, it may indicate an effusion or a problem with the cochlea. A delay after the cochlea may indicate a problem with the 8th nerve.

    I wouldn't let your imagination fly too far with this one yet (easy to say). If your child had a normal perinatal hearing test, that's good.

    Keep us updated.
     

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