Early detection of hearing impairment followed by early intervention and support is mandatory for the medical care of hearing-impaired children. Newborn hearing screening (NHS) is of great significance, although it is still not performed ubiquitously or widely. In children who have not undergone NHS or those with late-onset deafness, intervention and support tend to be delayed. Early intervention and support is important not only for children with severe or profound hearing loss, but also for those with mild to moderate hearing loss. When deafness is overlooked, it influences language acquisition, emotion, and the development of sociality. Children with profound deafness who are expected to obtain limited benefit from hearing aids require correspondence with consideration given to the choice of communication modes in their training and rehabilitation. When cochlear implant is considered as one of the most suitable choices, the candidate should be introduced without delay to medical facilities that specialize in providing medical care related to cochlear implantation. The age at cochlear implantation, cause of deafness, presence/absence of additional disability, and communication modes are associated with the degree of improvement of language comprehension and expression after the surgery. Various factors, including the above-mentioned, need to be considered to determine the suitability of a child for cochlear implant surgery, and care by a multidisciplinary team, including doctors and speech therapists, is necessary. In the medical treatment of hearing-impaired children, care needs to be provided not only to the affected children, but also to their parents, and long-term follow-up is required because of the dynamic developmental changes. Even simple audiological examinations require a high level of skill and know-how, and to understand the difficulty in the lives of the children and the needs of the parents, knowledge not only in the field of audiology, but also in the fields of developmental medicine and psychology is required. It is of particular importance to understand that an appropriate judgment made at the appropriate time is necessary to avoid a negative influence on the future development of deaf children.
Acute low-tone sensorineural hearing loss (ALHL) sometimes recurs and converts to Meniere's disease. The following has been reported as prognostic factors; the age at onset, period from onset to the first visit, hearing threshold of 1000Hz at the first examination, and the degree of hearing acuity. However, relationships between the hearing level and prognosis remain unclear. We examined 361 patients with ALHL who were admitted to Nagoya City University Hospital, and analyzed their background and prognosis. Thereafter, the data of 64 patients who were followed up for longer than 1 year were analyzed in detail to determine the relationship between the hearing level and the prognosis. The hearing level at the first visit had no relevance to the prognosis, whereas that at 1 month was significantly related to the prognosis. In conclusion, careful observation for 1 month is necessary because the hearing level can fluctuate in some cases.
With the inauguration of the anti-aging center at our hospital, anti-aging dock, we established health check-up services focused on hearing issues in December 2009. During the last 7 months until June 2010, 96 out of 216 people (44.4%) visiting the anti-aging dock were optionally registered with the “anti-aging hearing dock program”. Most of the visitors were between 70 and 79 years old, followed in frequency by those who were between 60 and 69 years old. The main motivation of the visitors was self-recognition of hearing troubles in their daily life. Multiple regression analysis showed that the brachial-ankle pulse wave velocity (PWV) was related to the hearing threshold at 8kHz. Furthermore, the intimal plus medial thickness of the carotid artery (IMT) was closely correlated to the hearing thresholds at 4 and 8kHz. These findings suggest that arteriosclerosis is strongly involved in the hearing loss at higher frequencies in elderly people.
We evaluated the benefits of Electric Acoustic Stimulation (EAS) for patients with normal or moderate hearing loss in the lower frequencies or steeply sloping severe high-frequency hearing loss, and determined the effects of EAS in individuals with residual lower frequency hearing. All patients underwent cochlear implantation by the round window approach as an atraumatic surgery, using the MED-EL FLEXeas electrode array. They received treatment with the DUET2 processor, which combines electric and acoustic stimulation in one device. Assessment using an audiological test battery was performed as follows: postoperative residual hearing in lower frequencies; Japanese monosyllable words and speech discrimination abilities were evaluated at the time-points of 1, 3, 6 and 12 months after the EAS. Low-frequency residual hearing was preserved in all three patients during the long-term observation after cochlear implantation. The audiological test results revealed significant efficacy and benefits of EAS as compared to electrical stimulation alone, especially under noisy conditions. Thus, lower-frequency hearing preservation is possible after cochlear implantation by the round window approach and use of the FLEXeas electrode. We suggest that EAS is an effective treatment strategy for partial deafness, and yields improvements in monosyllable word discrimination and speech perception, even in Japanese speakers.
We investigated the clinical histories, language development and the need for a hearing aid in 15 children with low-tone hearing loss. The ages of the children at diagnosis ranged from 1 year old to 8 years 8 months old. The pure-tone averages ranged from 27.5dB to 80.0dB. The age at diagnosis increased as the hearing level decreased. Delay of language development was found in 12 children. No delay of language development was found in the 3 children with a pure-tone average of less than 40dB, and these children did not need a hearing aid. The Decision on the need for a hearing aid was more difficult for children with mild hearing loss than for those with severe hearing loss. The threshold to decide on the need for a hearing aid was 40dB on the pure tone average, 50dB on 500Hz and 1000Hz, and 25dB on 2000Hz. After the introduction of Newborn Hearing Screening, children with mild-moderate hearing loss have been diagnosed earlier. However, the diagnosis of low-tone hearing loss is difficult. Earlier measurement of the threshold for each frequency and earlier evaluation of language development are important for early diagnosis and intervention.