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Catching Sensorineural Hearing Loss Early

Margaret Kenna, MD, MPH, with Boston Children’s Hospital and Harvard Medical School, was one of four panelists in yesterday’s session, “Medical Work-Up of Pediatric Sensorineural Hearing Loss.” Dr. Kenna presented in-depth statistics on congenital Cytomegalovirus (CMV) and genetic hearing loss.

When it comes to identifying and treating children with sensorineural hearing loss, it takes a village. Oliver F. Adunka, MD, the lead presenter in yesterday’s session, “Medical Work-Up of Pediatric Sensorineural Hearing Loss,” emphasized that otolaryngologists need to be involved in the process.

“I believe strongly in the fact that we as physicians need to stay involved,” said Dr. Adunka, with The Ohio State University. “We need to understand what audiologists are doing. Don’t just pass [the patients] along. You, as a physician, play a central role in this.”

All medical professionals—be they audiologists, family physicians, or otolaryngologists—are having a hard time reaching all of the children with hearing loss in the U.S. as is. Even though it is one of the most common birth defects—more than double the instances of cleft lips or palates, Down Syndrome, and limb defects combined—Craig A. Buchman, MD, with the Washington University School of Medicine, said otolaryngologists are getting less than 50 percent of all children who are candidates for cochlear implantation.

Untreated hearing loss, Dr. Buchman said, can lead to $1 million in lifetime cost for a child—much of which comes in as lost earning potential. Children who are deaf only reach an average of a third-grade reading level by age 18. The key in beating these statistics is identifying the problem.

“I tell parents the one thing they can do wrong after they’ve made it to us is to not show back up,” Dr. Buchman said.

The crux is how to catch the hearing loss—and how to get all states on board with best practices. Dr. Buchman cited states such as California and North Carolina that are doing more thorough screenings and investing more money versus states like Texas and Ohio that are missing large percentages of children with hearing issues.

An initial screen at the hospital after a child is born is important, but so is a rescreen. Dr. Buchman said states that are rescreening two weeks after birth as opposed to rushing a rescreen 12 hours after an initial screen have the right idea.

Another challenge is patients who do not return for follow-up.  Their failure to return could be for a variety of reasons—home births, a child being born in one state but going home with his or her parents to another, an incomplete screening before discharge, physician reassurance that there is no problem, and more.

The good news? The field is making dramatic progress.

“I tell patients now,” said Daniel Choo, MD, with Cincinnati Children’s Hospital Medical Center, “In your kid’s lifetime, we’re going to fix this.”

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