pediatrics
Hearing Impairment in Children
Etiology of Hearing Impairment in Children
Themost common causesof hearing loss in neonates are Congenital and Perinatal Cytomegalovirus Infection (CMV) (CMV) infection ( Genetic defects (see table Some Genetic Causes of Hearing Loss ) Congenital CMV infection is the most common intrauterine infection in the US. CMV infection may account for as much as 21% of all sensorineural hearing loss at birth. In addition, because CMV infection also may cause late-onset hearing loss, CMV may account for as much as 25% of sensorineural hearing loss present at 4 years of age ( Etiology references ). Risk factorsfor hearing loss in neonates include the following: Low birth weight (eg, < 1.5 kg) Apgar Score < 5 at 1 minute or < 7 at 5 minutes Hypoxemia or seizures resulting from a difficult delivery Prenatal infection with Congenital Rubella , Overview of Congenital Craniofacial Abnormalities , particularly those that involve the Neonatal Hyperbilirubinemia None Neonatal Sepsis or Ventilator dependence Drug-Induced Ototoxicity None Family history of early hearing loss Themost common causesof hearing loss in infants and children are Cerumen None Middle ear effusions, including Otitis Media (Acute) with effusion Other causes in older children include head injuries, loud noises (including loud music), Drug-Induced Ototoxicity (eg, aminoglycosides, thiazides), viral infections (eg, Risk factorsfor hearing loss in children include those for neonates plus the following: Skull fractures or traumatic loss of consciousness Otitis Media (Chronic Suppurative) None Neurodegenerative disorders, including Neurofibromatosis None Noise exposure Traumatic Perforation of the Tympanic Membrane None 1.Goderis J, De Leenheer E, Smets K, et al: Hearing loss and congenital CMV infection: A systematic review.Pediatrics134(5):972–982, 2014. doi: 10.1542/peds.2014-1173 2.Kimani JW, Buchman CA, Booker JK, et al: Sensorineural hearing loss in a pediatric population: Association of congenital cytomegalovirus infection with intracranial abnormalities.Arch Otolaryngol Head Neck Surg136(10):999–1004, 2010. doi: 10.1001/archoto.2010.156 