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The importance of hearing in childhood is difficult to overestimate. Thanks to the ability to hear, the child develops speech and communication skills.
Hearing loss at an early age is a very common problem. According to statistics, 3 children per 1000 newborns have serious hearing impairments. With age, the number of children with sensorineural, conductive or mixed hearing loss increases. In our Hearing Center, the principle of comprehensive diagnostics for detecting hearing disorders using high-precision PATH Medical equipment is applied (Germany) and Otometrics (Denmark). A highly qualified surdologist, an otolaryngologist compares the results of several hearing examinations and then makes an accurate and final diagnosis.
Methods of examinations in children
To identify pathology on the part of the child’s hearing organ, 2 research methods are used: subjective, which depends on the patient’s responses and requires contact with the child, and objective, independent of the child’s responses and does not require contact with the patient.
The subjective research method includes several types of audiometry. The objective method consists of a complex of examinations, namely, impedance measurement (tympanometry and acoustic reflex registration), otoacoustic emission, cochlear audiometry and auditory evoked potentials examination: VSWP, ASSR. The last two methods of examination make it possible to make a final diagnosis and establish the degree of hearing loss in young children.
It is based on observations of the child’s reaction to sound signals of different volume. It is used for newborns 2-4 months.
It is based on performing any game actions of the child on the sound heard at an older age, when the child is more active and curious. It is used at the age of 7 years. A unique development for children is the interactive game audiometry MAGIC from PAS Medical. Audiometry MAGIC is like real magic with the participation of a child, as a result of which the doctor receives a hearing examination of a small patient in the form of filled audiometry fields on the right and left ear. This examination can also be successfully used in adult patients who have difficulty removing tonal audiometry.
It is used at the age of 4-5 years, when the child can already give answers to the assigned tasks. First, through air headphones, and then through a bone phone, signals of different frequencies and different volume are sent to each ear in turn. The child, hearing the sound, presses the button or talks about it. The result of this study is depicted in two curves, the location of which allows us to assess the degree and type of hearing loss in children and adults.
With the help of tonal audiometry , the following hearing disorders can be determined:
It is an additional diagnostic method. With the help of it, the audibility thresholds of only the speech signal are detected. Usually speech audiometry is used at the age of 5 years. During its conduct, words are used. The child listens to them at different frequencies and with different volume, and then repeats. However, PAS Medical has developed a unique speech audiometry MATCH for children aged 3 (!) to 5 years. MATCH is an image-based speech audiometric testing for children. To identify speech intelligibility disorders in a noisy environment, the SUN speech comprehension test is used.
Includes tympanometry – the study of the mobility of the eardrum, which allows you to evaluate the work of the middle ear and the study of acoustic reflexes intra-ear muscles, that is, protective unconditioned reflexes to loud sounds. Impedancometry is performed for children with enlarged adenoids, frequent otitis media of the middle ear, suspected hearing loss. If it is necessary to check the function of the Eustachian tube with eustacheitis, tubotites, an ETF test can be carried out.
Auditory potentials of the brain- KSVP/ ABR.
The most complete comprehensive hearing examination in children. It is carried out during the natural or drug-induced sleep of the child. Signals are given that cause the activity of the auditory neurons of the brain. They are fixed by special sensors-electrodes attached to the child’s scalp and recorded by high-precision anti-interference equipment. This method allows you to evaluate the correctness of sound processing at the level from the cochlea to the brain stem inclusive and determine the thresholds of audibility at different frequencies. The audibility threshold is estimated by the presence or absence of the V wave of the VSWR. In modern devices, the CHIRP V wave registration method is used, which reduces the examination time and increases the visibility of the V wave. As a result, the exact location of the lesion of the auditory system is revealed. KSVP is indicated for children to detect sensorineural hearing loss, with a negative result of the otoacoustic emission test, with no reaction to quiet sounds, with delayed speech development.
With the help of this examination, the perception of sounds by the sensitive nerve endings of the hair cells of the cochlea of the inner ear is evaluated, since most of the pathologies are caused by the defeat of this part of the auditory system. With the help of a special probe with one or two microphones in the ear, the response of the hair cells to the sound signal is recorded. There are two types of otoacoustic emission: delayed, induced otoacoustic emission of TEOAE or ZVOAE and otoacoustic emission at the frequency of distortion products DPOAE or ECHPI. The unique frequency modulation emission algorithm developed by PATH Medical, called FMDPOAE, allows you to do the examination as accurately as possible, as well as to determine the child’s hearing at 13 speech frequencies. The DPOAE multi-frequency algorithm allows the examination to be carried out simultaneously on 4 frequencies, which reduces the examination time of the child. The screening emission of DPOAE from PATH Medical takes only a few seconds, which is extremely important for hearing examinations in young children.
Otoacoustic emission is the main screening method for detecting hearing disorders in newborns. The examination is shown to all children from the moment of birth. We draw the attention of parents that a hearing test / hearing screening must be done for ALL CHILDREN without EXCEPTION from the moment of birth! If your child has not had this examination at the maternity hospital, we recommend that you urgently undergo a hearing screening to exclude hearing loss, which threatens the child with a delay in speech development. The state program of mandatory newborn hearing screening operates in all developed countries of the world.
Objective cochlear computer audiometry.
Examination of the emission of distortion products DPOAE allows you to identify hearing thresholds by frequency and even plot hearing at all important speech frequencies or cochlear audiometry! Objective cochlear computer audiometry is a unique development of PAS Medical (Germany) and is successfully used in Ukraine in Hearing Centers for frequency diagnostics of hearing in children and adults.
It is indicated for children with delayed speech development, with suspected hearing loss in the absence of middle ear pathology (normal tympanogram).
Aboutcomputer audiometry ASSR
Auditory Steady-State Responses (ASSR) are responses at the level of the brainstem and subcortical structures of the brain to a modulated tone. Brain responses are recorded from sensors-electrodes superimposed on the child’s scalp. It is better to carry out the examination during the child’s sleep, but there is a possibility of diagnosis during the child’s quiet wakefulness.
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