Hearing Problems of Children

Hearing Loss Test for Children as of Newborn

When hear loss is detected in babies and children, the things to be realized for recovery of talking and not to lose talking ability are very important.  Hearing loss observed in infancy period affects development of talking in a negative way.  For this reason, newborn hearing screening should be performed for each baby for the early diagnosis of hearing loss regardless of its level.

All kinds of ear diseases and surgeries;

They consist of three basic sections being:

• External Ear
• Middle Ear
• Internal Ear

Ear:
Earlap and auditory canal constitute the external ear.  In the depth of ear canal, there is tympanic membrane that separates the external ear and middle ear. Tympanic membrane is a thin structure that vibrates when sound waves reached to it.  Middle ear is a cavity that is located behind the tympanic membrane and contains air.  Air is conveyed from nasal cavity to the middle ear by means of a small canal called Eustachian tube. Duty of Eustachian tube is to equalize the pressure of air in the middle ear cavity with the atmospheric pressure of outer environment.

Vibrations on the tympanic membrane created by the sound waves are transmitted to the internal ear by means of small ossicles (anvil, stirrup, malleus), and nerves that convey the sound to the brain are stimulated.  Otitis is the disease that is most frequently encountered in small children.  And otitis is mostly experienced as a result of inflammation of external and middle ear and obstruction of the canal that connects the ear and throat.  If these inflammations are not treated in time, they may be dangerous later on. Indications of ear pain are hypersensitivity, loss of appetite and fever.

Otitis External:
It is observed on the skin covering the exterior ear canal.  If your child stays in chlorinated water too much or puts a foreign substance into the ear and scratches the ear skin, external otitis may develop.  Its indications are ear pain when he/she lies down, redness on the exterior ear canal, ear discharge and itching of inside of the ear.

Otitis Media:
Acute otitis media is the inflammation of middle ear cavity behind the tympanic membrane.  Eustachian tube is smaller in children in comparison to adults, thus it is easier for microbes to reach to middle ear from the nose.  As a result of this, fluid accumulates in the middle ear, pressure imposed by the fluid causes pain and tympanic membrane not to vibrate.  Therefore, a little hearing loss is observed during otitis media.  When bacteria are killed by appropriate medication, fluid in the middle ear disappears and hearing gets better.

Acute otitis media is most frequently seen disease in the childhood.  2/3 of the children up to 3 years of age experiences otitis media at least for once.  Treatment of acute otitis media is realized by antibiotics.  In spite of an efficient antibiotic treatment, fluid that is not inflammatory stays in the middle ear and cause mild hear loss that gets better later on in 40% of the children for 3-6 weeks.  Otitis media is also seen frequently in children who have frequent upper respiratory tract infections.  For this reason, common cold and ear problems are encountered more in children who enter crowded environments such as nursery schools for the first especially in the first two years.

Indications and Findings:
Bigger children may state their complaints of aural fullness, pain and hearing loss.  First indications in the little children may be uneasiness, sleep disorder or loss of appetite.  Fever can be observed in children of all ages.  These indications are seen together with the complaints of upper respiratory tract that accompanies otitis media such as nasal discharge and coughing.  Perforation in the tympanic membrane may be observed in severe otitis media.  Consequently, inflammation in the middle ear runs down the ear canal, pain wears off and fever goes down.  Perforation on the tympanic membrane closes by itself as a result of the treatment.

Prevention of the disease:
Immunity of newborn babies provided by the agents in the breast milk prevents development of acute otitis media.  Position of babies fed with breast milk is more adequate for Eustachian tube to function normally in comparison to babies fed with bottle; for this reason, otitis media is experienced less by babies fed with breast milk in comparison to the babies fed with bottle.  If the baby should be fed with bottle, it is better to fed the baby in sitting position in stead of feeding by laying her/him down.

Duration of the disease:
Recovery time of otitis media may be different.  Recovery may be observed within 48 hours even though no treatment is made.  Sometimes, fluid stays in the middle ear for a duration ranging between 2 weeks and 2 months even though treatment is made with antibiotics.  Generally this fluid disappears by itself, however hearing may reduce within this time period.  Otitis media is not infectious, however upper respiratory tract infection which is the basic reason, may be infectious.

Medical treatment:
Acute otitis media is generally treated with antibiotics and drugs that shall improve function of Eustachian tube.  Sometimes it may be necessary to discharge the inflammation by making a small incision on the tympanic membrane (paracentesis) if tympanic membrane swells too much because of inflammation and causes intense pain.  After this procedure, tympanic membrane gets better within one week.  Parents are concerned about whether or not there will be a permanent hearing loss.  Probability of permanent hearing loss is fairly low if the disease is treated adequately and drugs are used in the dosage and time period recommended.

Ear diseases:

• External Auditory Canal Inflammation;
• Ear Tinnitus
• Vertigo
• Otitis Media
• Tinnitus
• Hearing Loss;
• Prominent Ear Aesthetics
• Prominent Ear Treatment

Ear is our hearing organ which is part of our interaction and communication with our environment.  It is composed of 3 basic sections being internal ear, middle ear and external ear.  Earlap collects the coming sounds and enables their transmission to the middle ear.  Middle ear conveys coming sound vibrations to the internal ear.  Internal ear converts sound vibrations into signals that can be transmitted by the nerves to the brain.  We perceive sounds by this mechanism.  Earlap does not have significance in terms of hearing, however it enables us to understand the direction of the coming sounds.  Ear has a vital importance in terms of functionality, it also has a high value in terms of aesthetics since it influences outer look because of its location.  The problem in prominent ear deformation, the angle between the ear and head is wider than normal.  Ears are located more open towards the front in prominent ear problem.

When is the treatment of prominent ear made?

Ear shape starts to develop as of infancy and its development is completed until 5 or 6 years of age.  Children of this age start receiving education, thus they walk into a social life.  The people they are in relationship with also increase since they made a circle of friends in this new environment.  Prominent ear surgery is preferred by a lot of families in order for the child not to be psychologically affected adversely from the criticisms and mocking they may be subjected in their new environment.   Prominent ear surgery, in other words autoplasty, is performed under general anesthesia for the individuals in childhood.  It may also be realized at older ages by local anesthesia by narcotizing only the ear, without giving general anesthesia.  The reason of preferring general anesthesia in children for the prominent ear aesthetics, is to enable the surgeon to work more easily, because child may be anxious and may not stay calm.  This surgery is realized at the rear side of the earlap.  Thus, it is one of the surgeries that has the lowest risk of appearance of the surgery scar.  You can return to your house after the completion of the surgery if prominent ear surgery is realized by local anesthesia. The impact of the narcotic drug continues for 3-4 hours, little pain is felt when the effect of drug wears off.  This pain does not influence the daily life and you shall be comfortable if you use adequate analgesics.

When the surgery is completed, ears are bandaged. These bandages are kept for 3 days.  They will be opened during the control after 3 days.  You can take a bath on the same day after your bandages are removed.  There shall be bruising and swelling after the prominent ear surgery and they will disappear approximately within one week.   It is necessary to protect ear for 3 months after the surgery from actions like pulling ear, bending the ear toward to front, etc.  These actions may cause breakage of internal stitches made on the cartilage of the ear during operation.  If internal stitches open or break, ear will take its previous shape. This situation does not give rise to an injury; however surgery should be repeated for correction.