Our son (age 8) has been diagnosed with a conductive hearing loss of the left ear. He failed to hearing tests at his school ( Sept. and Feb) and also in March at our local speech and hearing Center. His tympanograms are normal. No fluid was noted on inspection. Our ENT said that his hearing loss was conductive and was probably related to fusion of the bones. He correlated this with tuning fork testing and inspection. He has recommended surgery to correct this problem with a CT scan prior to this for further evaluation. He has recommended that we see a doctor in TAmpa or Birmingham for further evaluation and surgery. In reading a case study from you clinic we noted that this surgery is not recommended until adulthood if the child is functioning well. Our son does very well in school, has excellent verbal skills and has no learning problems. However, we do not want this to pose a problem for him later in life.Our ENT stated that if this problem is not corrected he could have nerve damage in his ear and a further decline in his hearing. Please advise us on what course of action may be best and what options we have. Thank you very much.
Reply: ----------------------------
If you are interested, there is a recent review of this topic published in The Otolaryngologic Clinics of North America in June 1994. The title of the article is "Correction of Conductive Hearing Loss in Children" by Briggs and Luxford, the latter author being from the House Ear Institute in Los Angeles.
It is generally recommended that children with unilateral (one-sided) conductive hearing loss that is not related to chronic otitis media, cholesteatoma, tympanic membrane perforation, etc. should be managed conservatively with preferential seating in school and possible with hearing aid amplification. Surgical exploration and correction of the unilateral conductive hearing loss is not recommended until the child is old enough to provide informed consent.
It should also be noted that if the unilateral conductive hearing loss in your child is indeed related to a congenital ossicular fusion, there is no reason to suspect that there would be any detriment to waiting until he is an adult before embarking on surgical correction. Specifically, I am unaware of any evidence that would suggest nerve damage might occur if one were to delay surgery until adulthood.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
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