We present herein outlines of tubotympanoaerody-namography (TTAG), sonotubometry and the infla tion-deflation test, which are the main approaches used to test Eustachian tube function. The Eustachian tube connects the middle ear to the nasopharynx, and is recognized as an organ which ventilates, drains and protects the middle ear. Eustachian tube dysfunction leads to various diseases of the middle ear and the Eustachian tube itself. The evaluation of Eustachian tube function is useful for assessment of the pathological condition and in reaching a decision about indication for surgical treatment. We should therefore grasp the principle of each test and interpretation of the results.
Bacterial meningitis is one of the most common causes of acquired sensorineural hearing loss in children. We describe a 3-year-old boy with BLNAR meningitis, complicated with moderate to severe hearing loss and equilibrium disorder. He was given antibiotics, steroids, glycerol and gabexate mesylate. About a half year later, his hearing loss recovered to a completely normal level. We suggest that the inner ear damage in this case might have been due to serous labyrinthitis.
In this report, the result of our follow-up study of those children with mild-to-moderate hearing loss who were born before the introduction of Newborn Hearing Screening is presented. The subjects were 30 children diagnosed at Kitasato University Hospital as having hearing loss less than 70dBHL, during the period from 2002 to 2004. The average age at their first visit to the hospital was 69 months, and the average hearing threshold level was 47dB. All the subjects were found to have communication problems. Delayed language development was noted in 27, while articulation disorders were found in 20. Following our habilitative intervention, 15 subjects adopted hearing aids all day long. Within several months of habilitation, active social commitment was observed. A year later, an improvement in language development was noted. Most of the parents had some difficulty in understanding the possible problems caused by hearing loss. The apparent lack of universal use of hearing aids seemed to be due partly to the ignorance of the parents or to their economical situation. It was stressed that developing an effective program must be put in place to promote the parents' recognition of various problems surrounding children with mild-to-moderate hearing loss.
Language development was evaluated among 7 hearing-impaired, school-aged children who were identified through newborn hearing screening. Six of the 7 cases were enrolled into our intervention program before they were 6 months of age and their hearing levels were finally confirmed by 10 months of age. No additional developmental delay was observed in 5 of the 7 cases and their monosyllable speech perception and speech intelligibility developed fairly well. Among these children, 4 children who used cochlear implants showed a normal range of language development as assessed by WPPSI. A borderline mentally retarded case with a cochlear implant developed her monosyllable speech perception and speech intelligibility in a fair manner, although she still showed mild delay in her language development. A patient who showed poor intra-postoperative NRT preferred to use visually presented information and demonstrated poor speech perception as well as speech intelligibility. His language skills gradually developed after addition of visual modalities. Greater benefit can be expected by combining available methods in accompaniment with newborn hearing screening and cochlear implants. These methods will become one of models for intervention in deaf children.