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Spitzer ER, Attlassy Y, Roland JT, Waltzman SB. Early cochlear implantation for children with single sided deafness. Int J Pediatr Otorhinolaryngol 2024; 177:111857. [PMID: 38244481 DOI: 10.1016/j.ijporl.2024.111857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 12/27/2023] [Accepted: 01/05/2024] [Indexed: 01/22/2024]
Abstract
OBJECTIVES Single-sided deafness (SSD) can have consequences for a child's language, educational, and social development. A cochlear implant (CI) is the only device which can restore true binaural hearing, yet they are only approved for children with (SSD) over the age of five in the United States. Reports on speech perception outcomes for children implanted at a younger age are limited. The present study aims to examine the effects of age at implantation, duration of deafness, hearing loss etiology, and presence of additional disabilities on device usage and speech perception outcomes. METHODS A retrospective chart review was used to examine demographics and speech perception outcomes for 18 children implanted at age five or younger. RESULTS Speech perception results were highly variable, with some children deriving significant benefit and others demonstrating no sound awareness through the implant alone. Age at implantation and duration of deafness did not have a clear impact on outcomes. Device usage was low in many children, often those with anatomical abnormalities such as a hypoplastic cochlear nerve. There are challenges to assessing speech perception in young children with SSD, leading to a lack of standardized outcome measures. CONCLUSIONS Early CI for children with SSD may improve speech perception, but benefit is not guaranteed. Candidacy evaluation should consider both medical and audiological factors, in addition to the degree of family support and realistic expectations. Caution is especially warranted in children with significant anatomical anomalies.
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Affiliation(s)
- Emily R Spitzer
- New York University Grossman School of Medicine, Department of Otolaryngology-Head and Neck Surgery, New York, NY, USA.
| | - Younes Attlassy
- New York University Grossman School of Medicine, New York, NY, USA
| | - J Thomas Roland
- New York University Grossman School of Medicine, Department of Otolaryngology-Head and Neck Surgery, New York, NY, USA
| | - Susan B Waltzman
- New York University Grossman School of Medicine, Department of Otolaryngology-Head and Neck Surgery, New York, NY, USA
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American Cochlear Implant Alliance Task Force Guidelines for Clinical Assessment and Management of Cochlear Implantation in Children With Single-Sided Deafness. Ear Hear 2022; 43:255-267. [PMID: 35213890 PMCID: PMC8862768 DOI: 10.1097/aud.0000000000001204] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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van Beeck Calkoen EA, Pennings RJE, Smits J, Pegge S, Rotteveel LJC, Merkus P, Verbist BM, Sanchez E, Hensen EF. Contralateral hearing loss in children with a unilateral enlarged vestibular aqueduct. Int J Pediatr Otorhinolaryngol 2021; 150:110891. [PMID: 34425354 DOI: 10.1016/j.ijporl.2021.110891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 07/01/2021] [Accepted: 08/13/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the long-term ipsi- and contralateral hearing of patients with a unilateral enlarged vestibular aqueduct (EVA). STUDY DESIGN Multicenter retrospective cohort study. SETTING Three tertiary otology and audiology referral centers. PATIENTS AND DIAGNOSTIC INTERVENTIONS A total of 34 children with a unilateral enlarged vestibular aqueduct as identified on CT and/or MR imaging were evaluated with pure tone and speech perception audiometry. MEAN OUTCOME MEASURES Radiologic measurements of the vestibular aqueduct, ipsi- and contralateral hearing loss, ipsi- and contralateral hearing loss progression over time and DNA test results. RESULTS All patients in this cohort with unilateral EVA presented with hearing loss. Hearing loss was progressive in 38% of the ipsilateral ears. In 29% of the children, hearing loss was also found in the contralateral ear without EVA. In 90%, the contralateral hearing was stable, with a mean follow up of 4.2 years. We found a significant correlation between the severity of the hearing loss and the size of the EVA. A genetic diagnosis associated with EVA and/or SNHL was found in only 7%. CONCLUSION About a third of the children with unilateral EVA are at risk of developing hearing loss in the contralateral ear. This indicates that at least in some patients with a unilateral EVA, a bilateral pathogenic process underlies the hearing loss, in contrary to what the imaging results suggest. These findings are important for counseling of EVA patients and their parents and have implications for follow up.
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Affiliation(s)
- E A van Beeck Calkoen
- Department of Otolaryngology-Head and Neck Surgery Ear & Hearing, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; Center for Diagnostics in Sensorineural Hearing Loss (CDS), VU University Medical Center, Amsterdam, the Netherlands.
| | - R J E Pennings
- Department of Otolaryngology-Head and Neck Surgery, Section Hearing and Genes, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
| | - J Smits
- Department of Otolaryngology-Head and Neck Surgery, Section Hearing and Genes, Radboud University Medical Center, Nijmegen, the Netherlands; Donders Institute for Brain Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
| | - S Pegge
- Department of Radiology, Radboud University Center, Nijmegen, the Netherlands
| | - L J C Rotteveel
- Department of Otolaryngology-Head and Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands
| | - P Merkus
- Department of Otolaryngology-Head and Neck Surgery Ear & Hearing, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; Center for Diagnostics in Sensorineural Hearing Loss (CDS), VU University Medical Center, Amsterdam, the Netherlands
| | - B M Verbist
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - E Sanchez
- Department of Radiology, VU University Medical Center, Amsterdam, the Netherlands
| | - E F Hensen
- Amsterdam Public Health Research Institute, Amsterdam, the Netherlands; Department of Otolaryngology-Head and Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands
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Acke FRE, Van Hoecke H, De Leenheer EMR. Congenital Unilateral Hearing Loss: Characteristics and Etiological Analysis in 121 Patients. Otol Neurotol 2021; 42:1375-1381. [PMID: 34172660 DOI: 10.1097/mao.0000000000003248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe the characteristics and etiological analysis in patients with congenital unilateral hearing loss. STUDY DESIGN Retrospective cohort analysis. SETTING Tertiary referral center. PATIENTS Children with permanent congenital unilateral hearing loss born between 2007 and 2018. Patients were referred after universal newborn hearing screening or by a colleague to confirm the diagnosis and perform etiological examinations. MAIN OUTCOME MEASURES Hearing loss type, severity, and evolution linked with the results of etiological testing. RESULTS In the 121 included children, aural atresia is the leading cause of congenital unilateral hearing loss (32%), followed by structural anomalies (19%) and cCMV (13%), whereas 24% remained idiopathic after etiological work-up. Severity is mainly moderately severe (33% with 56-70 dB hearing loss, majority aural atresia) or profound (31% with > 90 dB hearing loss, predominantly cochlear nerve deficiency). Syndromic features were present in 26%. Although discussed with all parents, only 26% of the children regularly used hearing amplification. CONCLUSIONS Congenital conductive unilateral hearing loss is mainly caused by aural atresia, which proportion in congenital unilateral hearing loss proved higher than previously reported. Cochlear nerve deficiency and cCMV are the predominant etiologies of congenital unilateral sensorineural hearing loss. Etiological work-up in affected patients is mandatory as it might impact the approach, and syndromic features should be actively searched for.
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Affiliation(s)
- Frederic R E Acke
- Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
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胡 健, 赵 晓, 仵 倩, 刘 贝, 陈 迟, 边 盼, 郭 玉, 徐 百. [Computer tomography demonstrations of single-sided deafness]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2020; 34:981-986. [PMID: 33254314 PMCID: PMC10133136 DOI: 10.13201/j.issn.2096-7993.2020.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Indexed: 06/12/2023]
Abstract
Objective:To investigate the distribution of common inner ear and internal auditory canal malformations in children with single-sided deafness(SSD) ,and to explore the imaging etiology of SSD by comparing the quantitative parameters of key bone structures between deaf and normal ears in children with congenital SSD. Method:Forty children with SSD diagnosed in the Second Hospital of Lanzhou University from September 2016 to March 2019 were collected. All of them underwent HRCT examinations of temporal bone . The area of bone island, the width of vestibular, the width of internal auditory canal, the height of cochlear and the width of cochlear basal axis were measured. Paired t test was used to compare the difference between the hearing abnormality and normal hearing in children with SSD. Result:The rate of inner ear deformity was 62.5% in SSD group,the most common deformity was cochlear nerve canal deformity, 20 cases (50.0%) of cochlear canal stenosis and 3 cases (7.5%) of cochlear canal atresia.The second most common deformity was internal auditory canal deformity, including 5 cases (12.5%) of internal auditory canal stenosis and 1 case (2.5%) of internal auditory canal atresia. Other malformations included 1 case(2.5%) of RO, 2 cases (5.0%) of incomplete partition (IP) type II and 1 case (2.5%) of enlargement of vestibular aqueduct (EVA). There are no significant difference in the measured results of the key structures of the inner ear between two groups except the width of cochlear nerve canal, internal auditory canal and the area of bone island. Conclusion:The main inner ear deformities in children with SSD are cochlear nerve canal stenosis and inner auditory canal stenosis. HRCT of temporal bone has high diagnostic value for inner ear deformities in children with SSD.
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Affiliation(s)
- 健 胡
- 兰州大学第二医院耳鼻咽喉头颈外科(兰州,730030)Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Lanzhou University, Lanzhou, 730030, China
| | - 晓云 赵
- 兰州大学第二医院耳鼻咽喉头颈外科(兰州,730030)Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Lanzhou University, Lanzhou, 730030, China
| | - 倩 仵
- 兰州大学第二医院耳鼻咽喉头颈外科(兰州,730030)Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Lanzhou University, Lanzhou, 730030, China
| | - 贝贝 刘
- 兰州大学第二医院耳鼻咽喉头颈外科(兰州,730030)Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Lanzhou University, Lanzhou, 730030, China
| | - 迟 陈
- 兰州大学第二医院耳鼻咽喉头颈外科(兰州,730030)Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Lanzhou University, Lanzhou, 730030, China
| | - 盼盼 边
- 兰州大学第二医院耳鼻咽喉头颈外科(兰州,730030)Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Lanzhou University, Lanzhou, 730030, China
| | - 玉芬 郭
- 兰州大学第二医院耳鼻咽喉头颈外科(兰州,730030)Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Lanzhou University, Lanzhou, 730030, China
| | - 百成 徐
- 兰州大学第二医院耳鼻咽喉头颈外科(兰州,730030)Department of Otorhinolaryngology Head and Neck Surgery, the Second Hospital of Lanzhou University, Lanzhou, 730030, China
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Carol Liu YC, Ibekwe T, Kelso JM, Klein NP, Shehu N, Steuerwald W, Aneja S, Dudley MZ, Garry R, Munoz FM. Sensorineural hearing loss (SNHL) as an adverse event following immunization (AEFI): Case definition & guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine 2020; 38:4717-4731. [PMID: 32418788 DOI: 10.1016/j.vaccine.2020.05.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 05/06/2020] [Indexed: 01/22/2023]
Abstract
This is a Brighton Collaboration case definition of the term "Sensorineural Hearing Loss" to be utilized in the evaluation of adverse events following immunization. The case definition was developed by a group of experts convened by the Coalition for Epidemic Preparedness Innovations (CEPI) in the context of active development of vaccines for Lassa Fever and other emerging pathogens. The case definition format of the Brighton Collaboration was followed to develop a consensus definition and define levels of diagnostic certainty, after an exhaustive review of the literature and expert consultation. The document underwent peer review by the Brighton Collaboration Network.
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Affiliation(s)
- Yi-Chun Carol Liu
- Department of Otorhinolaryngology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Titus Ibekwe
- Department of Otorhinolaryngology, University of Abuja, Nigeria
| | - John M Kelso
- Division of Allergy, Asthma and Immunology, Scripps Clinic, San Diego, CA, USA
| | - Nicola P Klein
- Kaiser Permanente Vaccine Study Center, Oakland, CA, USA
| | - Nathan Shehu
- Department of Pediatric Infectious Diseases, Jos University, Nigeria
| | - Wendy Steuerwald
- Department of Audiology, Phoenix Children's Hospital, Phoenix, AZ, USA
| | - Satinder Aneja
- Department of Pediatrics, School of Medical Sciences and Research, Sharda University, Gr Noida, India
| | - Matthew Z Dudley
- Department of International Health, and Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Flor M Munoz
- Department of Pediatrics, Section of Infectious Diseases, and Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA.
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Wu M, Zheng X, Wang X, Zhang G, Kuang J. 4q27 deletion and 7q36.1 microduplication in a patient with multiple malformations and hearing loss: a case report. BMC Med Genomics 2020; 13:31. [PMID: 32126996 PMCID: PMC7055054 DOI: 10.1186/s12920-020-0697-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 02/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chromosome deletions of the long arm of chromosome 4 in 4q syndrome are characterized by mild facial and digital dysmorphism, developmental delay, growth retardation, and skeletal and cardiac anomalies, which is regarded as an autism spectrum disorder. Moreover, some scarce reports indicate that patients with 4q interstitial deletion and 7p duplication may present symptoms associated with hearing loss. CASE PRESENTATION A boy with a severe developmental delay not only post-natal but also intrauterine and several dysmorphic features including microcephaly, ocular hypertelorism, exophthalmos, low-set ears, single palmar flexion crease, and overlapping toes presented discontinued cyanosis and recurrent respiratory infections. MRI, BAEP, echocardiogram and bronchoscopy revealed that he had persistent falcine sinus with a thin corpus callosum, left auditory pathway disorder, patent foramen ovale (2 mm), and tracheobronchomalacia with the right superior bronchus arising from the lateral posterior wall of the right main bronchus. Finally, the patient died with severe pneumonia at 10 months. Array CGH revealed a 23.62 Mb deletion at chromosome 4q27, arr [hg19] 4q27-q31.21 (121, 148, 089-144, 769, 263) × 1, and a 0.85 Mb duplication at chromosome 7q36.1, arr [hg19] 7q36.1-q36.2 (152, 510, 685-153, 363,5 98) × 3. It is rare for 4q syndrome cases or 7q duplications previously reported to have a hearing disorder, pulmonary dysplasia, and pulmonary arterial hypertension. CONCLUSIONS The phenotype of our patient mainly reflects the effects of haploinsufficiency of FGF2, SPATA5, NAA15, SMAD1, HHIP genes combined with a microduplication of 7q36.1.
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Affiliation(s)
- Maolan Wu
- Department of Pediatrics, XiangYa Hospital, Central South University, Changsha, China
| | - Xiangrong Zheng
- Department of Pediatrics, XiangYa Hospital, Central South University, Changsha, China.
| | - Xia Wang
- Department of Pediatrics, XiangYa Hospital, Central South University, Changsha, China
| | - Guoyuan Zhang
- Department of Pediatrics, XiangYa Hospital, Central South University, Changsha, China
| | - Jian Kuang
- Department of Pediatrics, XiangYa Hospital, Central South University, Changsha, China
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Lipschitz N, Kohlberg GD, Scott M, Greinwald JH. Imaging findings in pediatric single-sided deafness and asymmetric hearing loss. Laryngoscope 2019; 130:1007-1010. [PMID: 31132141 DOI: 10.1002/lary.28095] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/07/2019] [Accepted: 05/13/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine the imaging findings on computer tomography (CT) and magnetic resonance imaging (MRI) in pediatric single-sided deafness (SSD) and asymmetric hearing loss (ASH). METHODS The medical records of 189 pediatric patients with SSD and ASH were retrospectively reviewed, and imaging findings were compared. SSD was defined as unilateral profound hearing loss and contralateral normal hearing ear. In the ASH group, ASHw was defined as the worse hearing ear with profound hearing loss, while ASHb was defined as the better hearing ear with mild-moderate hearing loss. RESULTS There were 170 patients with SSD and 19 patients with ASH. In the SSD group, 83 patients (48.8%) had imaging findings associated with hearing loss. In the ASH group, such imaging findings were found in six (31.6%) of the ASHw and in five (26.3%) of the ASHb ears. The most common finding in the SSD group was cochlear nerve deficiency (50.6%), followed by cochlear dysplasia (39.8%) and enlarged vestibular aqueduct (26.5%). In the ASH groups, cochlear dysplasia was seen in three (50%) of ASHw ears and in two (40%) of the ASHb ears, and enlarged vestibular aqueduct was seen in three (50%) of ASHw ears and in two (40%) of the ASHb ears. CONCLUSION Imaging studies identified the etiology in half of the cases of SSD and in one-third of ASH patients. Our findings strongly support the use of imaging studies in the evaluation of pediatric SSD and ASH. LEVEL OF EVIDENCE 4 Laryngoscope, 130:1007-1010, 2020.
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Affiliation(s)
- Noga Lipschitz
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
| | - Gavriel D Kohlberg
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A
| | - Michael Scott
- Division of Audiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A
| | - John H Greinwald
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, U.S.A.,Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A
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Huttunen K, Erixon E, Löfkvist U, Mäki-Torkko E. The impact of permanent early-onset unilateral hearing impairment in children - A systematic review. Int J Pediatr Otorhinolaryngol 2019; 120:173-183. [PMID: 30836274 DOI: 10.1016/j.ijporl.2019.02.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 02/13/2019] [Accepted: 02/14/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Decision-making on treatment and (re)habilitation needs to be based on clinical expertise and scientific evidence. Research evidence for the impact of permanent unilateral hearing impairment (UHI) on children's development has been mixed and, in some of the reports, based on fairly small, heterogeneous samples. Additionally, treatment provided has been highly variable, ranging from no action taken or watchful waiting up to single-sided cochlear implantation. Published information about the effects of treatment has also been heterogeneous. Moreover, earlier reviews and meta-analyses published on the impact of UHI on children's development have generally focused on select areas of development. OBJECTIVES This systematic review aimed to summarize the impact of children's congenital or early onset unilateral hearing impairment on listening and auditory skills, communication, speech and language development, cognitive development, educational achievements, psycho-social development, and quality of life. METHODS Literature searches were performed to identify reports published from inception to February 16th, 2018 with the main electronic bibliographic databases in medicine, psychology, education, and speech and hearing sciences as the data sources. PubMed, CINALH, ERIC, LLBA, PsychINFO, and ISI Web of Science were searched for unilateral hearing impairment with its synonyms and consequences of congenital or early onset unilateral hearing impairment. Eligible were articles written in English, German, or Swedish on permanent unilateral hearing impairments that are congenital or with onset before three years of age. Hearing impairment had to be of at least a moderate degree with PTA ≥40 dB averaged over frequencies 0.5 to 2 or 0.5-4 kHz, hearing in the contralateral ear had to have PTA0.5-2 kHz or PTA0.5-4 kHz ≤ 20 dB, and consequences of unilateral hearing impairment needed to be reported in an unanimously defined population in at least one of the areas the review focused on. Four researchers independently screened 1618 abstracts and 566 full-text articles for evaluation of study eligibility. Eligible full-text articles were then reviewed to summarize the results and assess the quality of evidence. Additionally, data from 13 eligible case and multi-case studies, each having less than 10 participants, were extracted to summarize their results. Quality assessment of evidence was made adapting the Grades of Recommendations, Assessment, Development, and Evaluation (GRADE) process, and reporting of the results adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. RESULTS Three articles with the quality of evidence graded as very-low to low, fulfilled the eligibility criteria set. Due to the heterogeneity of the articles, only a descriptive summary could be generated from the results. Unilateral hearing impairment was reported to have a negative impact on preverbal vocalization of infants and on sound localization and speech perception both in quiet and in noise. CONCLUSIONS No high-quality studies of consequences of early-onset UHI in children were found. Inconsistency in assessing and reporting outcomes, the relatively small number of participants, low directness of evidence, and the potential risk of confounding factors in the reviewed studies prevented any definite conclusions. Further well-designed prospective research using larger samples is warranted on this topic.
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Affiliation(s)
- Kerttu Huttunen
- Faculty of Humanities, Logopedics, and Child Language Research Center, University of Oulu, Finland; PEDEGO Research Unit, University of Oulu, Finland; MRC Oulu, Oulu, Finland; Oulu University Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Oulu, Finland.
| | - Elsa Erixon
- Uppsala University, Department of Surgical Sciences, Section of Otorhinolaryngology and Head and Neck Surgery, Uppsala, Sweden.
| | - Ulrika Löfkvist
- University of Oslo, Department of Special Needs Education, Oslo, Norway; Karolinska Institute, Department of Clinical Science, Intervention and Technology, Stockholm, Sweden.
| | - Elina Mäki-Torkko
- Örebro University, School of Medical Sciences, Örebro, Sweden; Örebro University Hospital, Audiological Research Center, Örebro, Sweden.
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van Wieringen A, Boudewyns A, Sangen A, Wouters J, Desloovere C. Unilateral congenital hearing loss in children: Challenges and potentials. Hear Res 2019; 372:29-41. [PMID: 29395617 DOI: 10.1016/j.heares.2018.01.010] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/17/2017] [Accepted: 01/21/2018] [Indexed: 11/16/2022]
Abstract
The estimated incidence of sensorineural hearing impairment (>40 dB HL) at birth is 1.86 per 1000 newborns in developed countries and 30-40% of these are unilateral. Profound sensorineural unilateral hearing impairment or single sided deafness (SSD) can be treated with a cochlear implant. However, this treatment is costly and invasive and unnecessary in the eyes of many. Very young children with SSD often do not exhibit language and cognitive delays and it is hard to imagine that neurocognitive skills will present difficulties with one good ear. In the current paper we review the most recent evidence on the consequences of unilateral hearing impairment for auditory and neurocognitive factors. While data of both adults and children are discussed, we focus on developmental factors, congenital deafness and a window of opportunity for intervention. We discuss which etiologies qualify for a cochlear implant and present our multi-center prospective study on cochlear implants in infants with one deaf ear. The large, state-of-the art body of research allows for evidence-based decisions regarding management of unilateral hearing loss in children.
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Affiliation(s)
- Astrid van Wieringen
- KU Leuven - University of Leuven, Department of Neurosciences, Experimental ORL, Herestraat 49, 3000 Leuven, Belgium.
| | - An Boudewyns
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Wilrijkstraat 10, 2650 Edegem, Belgium
| | - Anouk Sangen
- KU Leuven - University of Leuven, Department of Neurosciences, Experimental ORL, Herestraat 49, 3000 Leuven, Belgium
| | - Jan Wouters
- KU Leuven - University of Leuven, Department of Neurosciences, Experimental ORL, Herestraat 49, 3000 Leuven, Belgium
| | - Christian Desloovere
- KU Leuven - University of Leuven, Department of Neurosciences, Experimental ORL, Herestraat 49, 3000 Leuven, Belgium; University Hospital Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium
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Asymmetric and unilateral hearing loss in children. Cell Tissue Res 2015; 361:271-8. [PMID: 26004144 DOI: 10.1007/s00441-015-2208-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 05/06/2015] [Indexed: 12/11/2022]
Abstract
Asymmetric and unilateral hearing losses in children have traditionally been underappreciated, but health care practitioners are now beginning to understand their effect on development and the underlying pathophysiologic mechanisms. The common wisdom among medical and educational professionals has been that at least one normal-hearing or near-normal-hearing ear was sufficient for typical speech and language development in children. The objective of this review is to illustrate, to the non-otolaryngologist, the consequences of asymmetric and unilateral hearing loss in children on developmental and educational outcomes. Etiology, detection, and management are also discussed. Lastly, implications for further research are considered.
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Nelson S, Andersen R, Anderssen SH. Hearing loss in children in Østfold county 2000-09. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2015; 135:132-6. [PMID: 25625991 DOI: 10.4045/tidsskr.13.0556] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND The Directorate of Health recommends hearing screening of all neonates with the aid of otoacoustic emissions (OAE). The goal is to achieve initiation of treatment before the child is six months old. Congenital hearing loss occurs in 1-3 per 1,000 newborns, and the purpose of this study was to identify the prevalence in a large Norwegian dataset. METHOD AND MATERIAL During the period 1 January 2000-31 December 2009, all children who were born in Østfold county, 29,485 neonates in total, were offered hearing screening with the aid of otoacoustic emissions. Those children in whom no emissions were detected were referred to the hearing centre. The dataset also includes children born during the same period who had normal emissions during their neonatal period, but later were diagnosed with hearing loss. The follow-up period of these children lasted until 31 December 2013. RESULTS Altogether 568 children were referred to the hearing centre after screening. Of these, 73 children underwent brainstem response audiometry under anaesthesia, and 31 (0.11%) were diagnosed with hearing loss through absence of emissions at birth. Eleven (35%) of these received their diagnosis before the age of six months. The median age of diagnosis decreased from 13 (7-74) to 6 (3-23) months, while their number increased from nine to 22 from 2000-04 to 2005-09. Hearing loss after normal otoacoustic emissions at the neonatal stage was diagnosed in ten children (0.03%) and the median age of diagnosis among these was 36 (18-86) months. After the introduction of automated auditory brainstem response audiometry (AABR) during sleep, the use of auditory brainstem response audiometry (ABR) under narcosis fell by half. INTERPRETATION The prevalence of hearing loss is equal to other Norwegian and international figures. The age of diagnosis decreased during the period. Otoacoustic emissions appear to be an effective screening method in paediatric wards. The use of automated auditory brainstem response audiometry reduces the need for testing under narcosis.
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Affiliation(s)
- Siri Nelson
- Barneavdelingen Sykehuset Østfold Fredrikstad * Nåværende arbeidssted: Svensedammen Legesenter Drammen
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Computed tomography demonstrates abnormalities of contralateral ear in subjects with unilateral sensorineural hearing loss. Int J Pediatr Otorhinolaryngol 2014; 78:268-71. [PMID: 24359976 DOI: 10.1016/j.ijporl.2013.11.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 11/15/2013] [Accepted: 11/17/2013] [Indexed: 11/21/2022]
Abstract
PURPOSE Prior studies have associated gross inner ear abnormalities with pediatric sensorineural hearing loss (SNHL) using computed tomography (CT). No studies to date have specifically investigated morphologic inner ear abnormalities involving the contralateral unaffected ear in patients with unilateral SNHL. The purpose of this study is to evaluate contralateral inner ear structures of subjects with unilateral SNHL but no grossly abnormal findings on CT. MATERIALS AND METHODS IRB-approved retrospective analysis of pediatric temporal bone CT scans. 97 temporal bone CT scans, previously interpreted as "normal" based upon previously accepted guidelines by board certified neuroradiologists, were assessed using 12 measurements of the semicircular canals, cochlea and vestibule. The control-group consisted of 72 "normal" temporal bone CTs with underlying SNHL in the subject excluded. The study-group consisted of 25 normal-hearing contralateral temporal bones in subjects with unilateral SNHL. Multivariate analysis of covariance (MANCOVA) was then conducted to evaluate for differences between the study and control group. RESULTS Cochlea basal turn lumen width was significantly greater in magnitude and central lucency of the lateral semicircular canal bony island was significantly lower in density for audiometrically normal ears of subjects with unilateral SNHL compared to controls. CONCLUSION Abnormalities of the inner ear were present in the contralateral audiometrically normal ears of subjects with unilateral SNHL. These data suggest that patients with unilateral SNHL may have a more pervasive disease process that results in abnormalities of both ears. The findings of a cochlea basal turn lumen width disparity >5% from "normal" and/or a lateral semicircular canal bony island central lucency disparity of >5% from "normal" may indicate inherent risk to the contralateral unaffected ear in pediatric patients with unilateral sensorineural hearing loss.
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Haffey T, Fowler N, Anne S. Evaluation of unilateral sensorineural hearing loss in the pediatric patient. Int J Pediatr Otorhinolaryngol 2013; 77:955-8. [PMID: 23582232 DOI: 10.1016/j.ijporl.2013.03.015] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 03/08/2013] [Accepted: 03/10/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVES This study is a review of our series of pediatric patients with unilateral sensorineural hearing loss (USNHL) to report abnormalities on imaging studies, review genetic and ophthalmologic results, and survey audiometric findings. METHODS This study is a retrospective chart review of all pediatric patients with USNHL seen between 1/1/03 and 12/31/08 at our institution. The study was approved by the institutional review board. RESULTS Eighty-nine cases were identified with audiometric findings confirming unilateral hearing thresholds greater than 20 dBHL with no conductive component. There were 48 males and 41 females. Average age of diagnosis was 7 years. One audiogram showed low-frequency loss, 17 mid-frequency, 29 high-frequency, and 32 flat. Ten patients were diagnosed by auditory brainstem response testing at another institution, with thresholds not available for review. Eleven percent of patients progressed to bilateral loss. Sixty-one patients underwent computed tomography of temporal bones (CTTB). Twenty of 61 scans identified 34 anomalies including 15 enlarged vestibular aqueducts (EVAs), 8 Mondini, and 3 superior semicircular canal dehiscences (SSCDs). Thirty-one of 89 patients underwent magnetic resonance imaging (MRI). Three of these 31 patients had positive findings including 1 EVA, 1 Mondini, and 1 asymmetric internal auditory canal. When CTTB was positive, no additional lesions were detected on MRI. When CTTB was negative and MRI was done in 20 patients, 2 additional lesions were detected by MRI. Fourteen patients had genetics evaluation of which 6 had positive findings, including CHARGE, VACTERL, Goldenhar, and 3 were heterozygous for a Connexin mutation. CONCLUSIONS CTTB is an effective diagnostic tool for USNHL. MRI should be considered in patients with negative CTTB. Genetics and ophthalmologic evaluations are recommended for patients with risk factors or an abnormal clinical examination. Close follow-up is essential due to high rate of hearing loss progression.
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Affiliation(s)
- Timothy Haffey
- Section of Pediatric Otolaryngology, Head & Neck Institute, Cleveland Clinic, Cleveland, OH 44195, United States
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Santos S, Sgambatti L, Bueno A, Albi G, Suárez A, Domínguez MJ. Hipoacusia en niños con acueducto vestibular dilatado. Estudio de 55 casos. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2010; 61:338-44. [DOI: 10.1016/j.otorri.2010.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Revised: 03/28/2010] [Accepted: 04/07/2010] [Indexed: 10/19/2022]
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Santos S, Sgambatti L, Bueno A, Albi G, Suárez A, Jesús Domínguez M. Enlarged vestibular aqueduct syndrome. A review of 55 paediatric patients. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2010. [DOI: 10.1016/s2173-5735(10)70062-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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