Acquired Hearing Impairment in Children

Question 1

What may conductive deafness be due to?

Answer 1

A problem in:

• Canal
• Ossicles
• Middle Ear
• Tympanic membrane.

Question 2

What can be the problem with the ear canal?

Answer 2

It can be obstructed by wax or a foreign body which can cause conductive hearing loss.

Question 3

Ear canal problems can rarely cause…

Answer 3

Significant hearing impairment.

Question 4

What is acute otitis media?

Answer 4

Otitis media is an infection of the middle ear that causes inflammation (redness and swelling) aka. EAR INFECTION.

Question 5

Acute Otitis Media is very common, especially in _________.

Answer 5

Pre-school children.

Question 6

In acute otitis media, complications are ______.

Answer 6

Rare.

Question 7

How long does acute otitis media last usually?

Answer 7

3 to 5 days.

Question 8

With Acute otitis Media, we don’t expect any long term…

Answer 8

Hearing Problems.

Question 9

What can be a problem with the eat drum?

Answer 9

It can be perforated- a part of the ear drum or the whole ear drum could be missing?

Question 10

Do perforations affect hearing?

Answer 10

YES.

Question 11

What can perforations also cause?

Answer 11

Discharge.

Question 12

How are perforations fixed?

Answer 12

Sometimes they may heal on their own.

Or they may have to be repaired.

Question 13

Name the proper name for Glue Ear.

Answer 13

Otitis Media with Effusion.

Question 14

What is otitis media with effusion?

Answer 14

-Middle ear fluid is present for 3 months without any sign of infection.

Question 15

Glue ear is very _______.

Answer 15

Common.

Question 16

Why is otitis media with effusion known as glue ear?

Answer 16

As the collection of fluid behind the ear drum is thick and “glue like”.

Question 17

What is the point prevalence of glue ear in 2 year olds?

Answer 17

20% of 2 year olds will have it.

Question 18

What is the cumulative incidence of glue ear by age 5?

Answer 18

80% of kids by age 5 will have had it at some time.

Question 19

What are the clinical features of glue ear?

Answer 19

• most common in Pre-school child
• Can cause mild conductive hearing loss
• Can cause speech delay
• Also recurrent acute otitis media
• Asymptomatic- very subtle, no pian

Question 20

What are the risk factors for glue ear?

Answer 20

• Male sex
• Smoke exposure
• Family Size (big)
• Day Care
• Bottle Feeding
• Winter month (congested upper respiratory tract)
• Acute otitis media

Question 21

Glue ear is rare in _________ __________.

Answer 21

Older children.

Question 22

Why is glue ear sometimes not treated?

Answer 22

It’s often relatively short-lived, benign and will get better on it’s own.

Question 23

For Glue ear, what do we do before treatment?

Answer 23

3 months watchful waiting.

Question 24

For medical management of glue ear, what is a complete waste of time?

Answer 24

• Antibiotics
• Steroids (oral, topical nasal)
• Antihistamines
• Decongestants
• Nasal Balloons

Question 25

How is glue ear medically managed?

Answer 25

Through surgery.

Question 26

Name the surgery performed to get rid of glue ear.

Answer 26

-Insertion of Ventilation Tubes (grommets) | They give temporary symptomatic relief and improve hearing and infections.

Question 27

After 6 to 12 moths, what happens to the ventilation tube (grommet)?

Answer 27

They fall out.

Question 28

What is an advantage of ventilation tube surgery?

Answer 28

-painless, 2 minute surgery, come and go on same day

Question 29

After glue ear surgery, what happens?

Answer 29

The child wakes up with normal hearing so has to adjust.

Question 30

Apart from ventilation tube surgery, name another type of surgery to get rid of glue ear.

Answer 30

Adenoidectomy.

Question 31

What is adenoidectomy?

Answer 31

Removal of adenoids.

Question 32

Why are the adenoids removed to stop glue ear?

Answer 32

It removes the source of infection and inflammation (removes obstruction).

Question 33

______ are small lumps of tissue at the back of the nose, above the roof of the mouth.

Answer 33

adenoids.

Question 34

What are the advantages of adenoidectomy surgery?

Answer 34

- sustained benefit (years) | - quality of life benefit.

Question 35

In adeniodectomy what is there a small risk of?

Answer 35

Bleeding.

Question 36

Glue ear is very ______.

Answer 36

Common.

Question 37

Glue ear is usually b______ and s_____-l______.

Answer 37

Benign and self-limiting.

Question 38

When would glue ear warrant surgery?

Answer 38

If it causes hearing impairment or lots of infection.

Question 39

Name the 2 treatment choices for glue ear.

Answer 39

- Grommets | - Adenoidectomy

Question 40

Apart from falling out, what is another problem with grommets/ventilation tubes?

Answer 40

They can sometimes cause infection.