Ear Disease / Hearing Loss

The two main types of hearing loss are sensorineural and conductive. Both types of hearing loss can be present at birth, or they can develop later in life.

Hearing Loss in Babies

According to the National Institutes of Health (NIH), nearly 12,000 babies are born each year in the United States with a permanent hearing impairment. It is estimated that serious hearing loss occurs in about one to three of every 1,000 healthy newborns, and in two to four of every 100 babies in newborn intensive care units. Without hearing testing, significant hearing loss may not be noticed until the baby is over a year of age. Profound deafness is often not recognized until 18 to 24 months of age. Lesser degrees of hearing loss may not be recognized until 3 to 6 years of age. Although these children are not meeting normal developmental milestones, this situation is often unrecognized, or attributed to other causes.

The sooner hearing loss is identified and treated, the less likely there will be a significant impact on development of language. Recent studies indicate that intervention by 6 months of age is very beneficial in terms of prevention of language delays in early childhood.

Sensorineural hearing loss is a hearing loss caused by dysfunction of the inner ear or the hearing nerve. These types of hearing loss are usually congenital and genetic in nature and can present either immediately after birth or some times even a few years later. Depending on the severity of the hearing loss, amplification can be achieved either by the use of hearing aids or, in severe cases, a cochlear implant can be recommended. As a pediatric ENT specialist, Dr. Shinhar will be able to suggest the proper course of treatment for the child with hearing loss. Conductive hearing loss, however, pertains to hearing loss that is caused by dysfunction in the conduction mechanism of the middle ear. This can be due to a variety of reasons beginning with fluid in the middle car, which is a very common medical condition in young children, all the way to abnormalities or discontinuation in the middle ear bones that are responsible for conduction of sound. The treatment for conductive hearing loss is usually surgical. It ranges from drainage of the fluid and insertion of ear tubes, all the way to surgical exploration of the middle ear and correction of middle ear bone abnormalities, including insertion of special implants to restore hearing. Dr. Shinhar has extensive experience in all types of middle ear surgeries and will be able to recommend and assist your child in order to restore conductive hearing loss.

Ear disease can generally be divided into two types, acute ear disease which includes ear infections that lead to pain, temporary hearing loss, and occasionally drainage from the ears. These can usually be treated with proper medication including antibiotics and ear drops. More complex are the chronic ear diseases, particularly cholesteatoma, which is a chronic infectious process that destroys the structures of the middle and inner ear. As a pediatric ENT surgeon, Dr. Shinhar specializes in the diagnosis and treatment of cholesteatoma. Usually, this will require surgical intervention to eradicate the disease and, in certain cases, to restore the damaged hearing by using special implants in the middle ear. Other issues can include congenital abnormalities in the ear canal and middle ear such as a very narrow ear canal, bony growth inside the ear canal that narrows its lumen, and abnormality in the structure of the middle ear bones. These also will require surgical intervention. Again, Dr. Shinhar will be able to offer you the full variety of surgical treatments for any of these conditions. Perforations in the ear drums are also a common sequela of chronic ear infections or some times remain in the ear drums after multiple tube insertions. They can lead to chronic drainage from the ears and hearing loss. These perforations can be surgically closed and sealed so that your child can return to normal function and regain normal hearing.


Myringotomy Tube Insertion

For children who suffer from chronic middle ear effusion or fluid behind the ear drum that leads to hearing loss, and some times problems with speech development, the solution is often surgical drainage of the fluid and insertion of pressure equalizing tubes into the ear drum. This is a very common procedure performed under general anesthesia and has no pain or discomfort associated with it for your child. Myringotomy tubes are temporary and usually stay in the ear drums anywhere between six months to two years, and then work their way out of the ear on their own. They require continuous follow up every few months to determine the condition of the tubes. If your child suffers from consistent fluid in their ears, they may be a candidate for insertion of tubes.