Pediatric Hearing Loss

Conductive hearing loss results from something blocking the sound conducting mechanism of the ear. This can be due to a buildup of earwax, fluid in the middle ear, a growth of tissue (cholesteatoma) or problems with the small hearing bones (ossicles). Treating conductive hearing loss can range from taking antibiotics to surgical intervention depending on the type and severity of the condition.

Sensorineural hearing loss is often considered permanent hearing loss because of nerve or inner ear damage caused by advanced age, continued exposure to loud noises, illness, ear trauma and more. Sensorineural hearing loss is typically addressed with hearing aids, but depending on the severity of your child's hearing loss, may treated through surgical or implantable devices, such as a cochlear implant.

Mixed hearing loss occurs when your child has hearing issues resulting from both conductive and sensorineural causes. With mixed hearing loss, there is typically a combination of issues that impact the outer, middle and/or inner ears.

Not every child with hearing loss was at risk, but it is still important to know what can predispose your child to having hearing loss before or after birth. Common risk factors include:

• Family history of hearing loss (including genetic conditions)
• Neurodegenerative disorders, such as Hunter syndrome and Friedreich ataxia
• Syndromes related to hearing loss, such as neurofibromatosis and Ushers syndrome
• In-womb infections
• Contracting a disease that can impact hearing loss, including meningitis, chickenpox and rubella
• Severe head trauma

It can be difficult to identify if your child has hearing loss, but some common signs of hearing loss include:

• Doesn’t startle at loud noises
• Doesn’t respond when his or her name is called
• Is not progressing with speech or language
• Difficulty following conversations and having issues responding or articulating
• Is having issues following/understanding lessons at school
• Turns up the volume of the TV, tablet, cellphone or other digital devices to extremely high levels
• Suffers from reoccurring earaches and ear pain

Contact your child's physician if you are worried that your child may be at risk for hearing loss and are experiencing one or more of the above symptoms.

If you are questioning whether or not your child is having difficulty hearing, early diagnosis is critical for treating any potential hearing loss before the condition worsens and causes further speech and language delays. The University of UChicago Medicine Comer Children’s Hospital pediatric otolaryngologists are committed to diagnosing your child’s hearing loss, and determining the best treatment strategy.

Audiological Exam

Comer Children’s audiologists will use a series of tests to pinpoint if hearing loss is present and characterize what type(s) it is. We will be testing your child's outer, middle and inner ear functions, including testing sound and word detection, using noninvasive, painless techniques. A comprehensive evaluation typically takes about 30 minutes to complete, but can vary depending on the studies needed.

• Pure Tone Audiogram is the foundational assessment used to determine your child's ability to hear different tones at various volumes across the normal range of human hearing. The test also studies your child’s ability to recognize spoken words. 
• Tympanogram measures the function of your child's eardrum and how well it vibrates. It can indicate problems with middle ear pressure or conditions like an eardrum perforation. 
• Auditory Brainstem Response (ABR) assess how the sounds are being transferred along the hearing nerve and brain. It is similar to an EEG which measures brain waves.
• Otoacoustic Emissions test the function of hair cells within the inner ear (cochlear).
• Tuning fork tests are the most basic audiological tests used to measure hearing loss.
• Behavioral Audiometry Evaluation: For younger children, behavioral or conditioned play test measures are conducted to assess a child’s hearing levels.

Computerized Tomography (CT)

A CT will provide our team with a clear image of your child’s bony ear anatomy in order to assess the integrity of the hearing bones, size and shape of the hearing and balance organs, and look for problems caused by chronic infections.

Magnetic Resonance Imaging (MRI)

An MRI is performed to identify a growth or tumor in or around the inner ear that could be causing hearing loss. It can also provide detailed information about the structure of the hearing and balance organs.

Genetic Testing

Many cases of childhood hearing loss are a result of genetic (inherited) problems, so certain blood tests may done to confirm or rule out any inherited conditions. In some instances, a referral your child to our pediatric genetics team.

Medical Evaluation

Our ear surgeons will perform an exam of your child’s ear, sometimes with a microscope, to look at the outer and middle ear structures. 

Speech and Language Evaluation

Speech and language delays are often seen in children with hearing loss, so our speech-language pathologist will work with your child to improve their speaking abilities due to hearing loss. 

When entrusting your child to the hearing loss experts at the University of Chicago Medicine Comer Children's Hospital, you can expect a treatment plan that is personalized for your child's specific needs. Our multidisciplinary team collaborates to create an individualized treatment plan that is designed to effectively and efficiently improve your child’s hearing loss.

Medical Care

For some children, medication will be enough to treat their condition. For instance, if he or she has frequent ear infections, we may prescribe antibiotic pills or drops. Steroids can also be used to treat inflammation or sudden hearing loss.  

Ear Tubes

When fluid from ear infections builds up behind the eardrum, or if your child gets frequent ear infections, ear tubes can be placed in the eardrum to help regulate air pressure and prevent fluid from recurring. Typically, the tube will fall out on its own and your child’s eardrum will heal. 

Repairing Middle Ear Bones

There are several surgical treatments available for the outer and middle ear conditions:

• Ossicular Chain Reconstruction (Ossiculoplasty): When your child has one or more damages or missing middle ear bones, we can replace the bones using prosthetics that mimic our natural hearing bones and improve overall hearing.
• Tympanoplasty: A perforated eardrum that has not healed on its own can be surgically closed to improve hearing and prevent infection. During a tympanoplasty, we place graft materials (such as cartilage or fascia) under the eardrum to promote the eardrum to heal. 
• Stapedotomy: For children with otosclerosis (a condition where the third hearing bone, the stapes bone, stops vibrating correctly), a stapedotomy removes the existing stapes bone and replacing it with a prosthetic device.
• Aural Atresia Repair: If your child who were born without an ear canal or developed severe narrowing of the ear canal, performing aural atresia repair will restore the natural sound to the middle ear. This procedure involves creating a new eardrum with fascia tissue and a skin graft to create a new ear canal. 

Hearing Aids

For children who need them, a hearing aid can amplify sound in their ear and improve overall hearing. In order to deliver the level of hearing restoration needed, we offer a variety of hearing aid devices. Our pediatric audiologists will help you select the best hearing aid, discuss how to wear it, ensure it fits comfortably and program it to your child’s unique pattern of hearing loss

Cochlear Implants

When hearing aids are no longer providing benefit to your child, a cochlear implant can help restore hearing. Unlike a hearing aid that only amplifies sound, cochlear implants actually transmits an electrical signal directly to your child’s inner ear (cochlea). After the cochlear implant is turned on, your child will attend quarterly speech therapy sessions to develop his or her listening and spoken language. The goal is to allow your child to improve their ability to communicate and it can result in a remarkable improvement in speech and language development. Learn more about cochlear implants