2010-09-24 / Columnists

Have You Heard?


The most common cause of hearing loss in young children is OTITIS MEDIA, or middle ear infection. What is otitis media?

Otitis media is an inflammation in the middle ear (the area behind the eardrum) that is usually associated with the buildup of fluid. The fluid may or may not be infected.

Symptoms, severity, frequency, and length of the condition vary. At one extreme is a single short period of thin, clear, non-infected fluid without any pain or fever but with a slight decrease in hearing ability. At the other extreme are repeated bouts with infection, thick “glue-like” fluid and possible complications such as permanent hearing loss. Fluctuating hearing loss nearly always occurs with all types of otitis media.

How common is otitis media?

Otitis media is the most frequently diagnosed disease in infants and young children. Seventy-five percent of children experience at least one episode of otitis media by their third birthday. Almost one-half of these children will have three or more ear infections during their first three years of life. Health costs for otitis media in the United States have been reported to be $3 billion to $5 billion per year and include the cost of a parent being unable to work to care for their sick child.

Why is otitis media so common in children?

The Eustachian Tube, a passage between the middle ear and the back of the throat, is smaller and more nearly horizontal in children than in adults.

The ear, nose and throat are connected at the opening of the Eustachian tube.

Enlarged adenoids, upper respiratory infections or colds, and bacteria or viruses that cause a sore throat can easily invade the Eustachian tube and result in otitis media. Until the Eustachian tube changes in size and angle as the child grows, children are more susceptible to otitis media. How can otitis media cause a hearing loss?

Three tiny bones in the middle ear carry sound vibrations from the eardrum to the inner ear. When fluid is present, the vibrations are not transmitted efficiently and sound energy is lost. The result may be mild or even moderate hearing loss. Therefore, speech sounds are muffled or inaudible.

Generally, this type of hearing loss is temporary and treatable. However when otitis media occurs over and over again, damage to the eardrum or the bones of the ear can occur and cause a permanent hearing loss. Can hearing loss due to otitis media cause speech and language problems?

Children learn speech and language from listening to other people talk. The first few years of life are especially critical for this development. If a hearing loss exists, a child does not get the full benefit of language learning experiences.

Otitis media without infection presents a special problem because symptoms of pain and fever are usually not present. Therefore, weeks and even months can go by before parents suspect a problem.

During this time, the child may miss out on some of the information that can influence speech and language development. How can I tell if my child might have otitis media?

Even if there is no pain or fever, there are other signs you can look for that may indicate chronic or recurring fluid in the ear:


Wanting the television or radio louder than usual;

Misunderstanding directions; Listlessness;

Unexplained irritability;

Pulling or scratching at the ears . What should I do if I think that otitis media is causing a hearing, speech, or language problem?

A physician should handle the medical treatment.

Ear infections require immediate attention, most likely from a pediatrician or otolaryngologist (ear doctor). If your child has frequently recurring infections and/or chronic fluid in the middle ear, an Audiological Evaluation by a licensed, certified, pediatric Audiologist is crucial.

An audiologist’s evaluation will assess the severity of any hearing impairment, even in a very young or uncooperative child, and will indicate if a middle ear disorder is present. The information gathered by the audiologist will assist the parents and physicians in making decisions about the best way to treat the disorder.

Will my physician refer my child for these special evaluations?

As a parent, you are the best person to look for signs that suggest poor hearing.

The American Academy of Pediatrics recognizes this when it states, “Any child whose parent expresses concern about whether the child hears should be considered for referral for behavioral audiometry without delay”.

Parents should not be afraid to let their instincts guide them in requesting or independently arranging for further evaluation whenever they are concerned about their children’s health or development.

If you have any questions, or are concerned that your child may be exhibiting signs of hearing loss, please call Dr. Shirley Pollak at Rockaway Audiology and Hearing Aid Center to schedule an appointment.

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