Paeds Vivas · ent-hearing-and-oral-health
Hearing assessment and childhood hearing loss — branching viva
Branching viva from the definition and the conductive-versus-sensorineural classification through the newborn screening programme and the 1-3-6 milestones, congenital CMV as the commonest acquired cause, the glue-ear grommet decision with the Paradise evidence, and the audiological emergency of post-meningitis hearing loss.
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Study tools
Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
You are the paediatric registrar. The consultant asks you to talk through four children: a baby who refers on the newborn hearing screen, a NICU graduate with possible auditory neuropathy, a preschool child with persistent bilateral glue ear whose parents want grommets, and a toddler recovering from pneumococcal meningitis who needs a hearing assessment.
Station opening
Examiner: "Define childhood hearing loss and classify it by site, and explain why the newborn hearing screen exists at all." [1]
Strong candidate (must-hit)
- Defines childhood hearing loss as reduced sensitivity or disordered neural processing of sound that threatens language development; classifies it into conductive (outer or middle ear), sensorineural (cochlea or auditory nerve) and mixed, distinguished by the air-bone gap on the audiogram; explains that a newborn with permanent hearing loss is clinically silent, so universal screening finds the loss before any parent or clinician could, during the critical period of auditory development. [1] [2]
Weak candidate
- "Children who can't hear present with deafness, and we test the ones whose parents are worried." [1]
References7ShowHide
- [1]Korver AMH; Smith RJH; Van Camp G; Schleiss MR; et al Congenital hearing loss. Nat Rev Dis Primers, 2017.PMID 28079113
- [2]Butcher E; Dezateux C; Cortina-Borja M; Knowles RL Prevalence of permanent childhood hearing loss detected at the universal newborn hearing screen: Systematic review and meta-analysis. PLoS One, 2019.PMID 31295316
- [5]Sininger YS; Cone-Wesson B; Folsom RC; Gorga MP; et al Identification of neonatal hearing impairment: auditory brain stem responses in the perinatal period. Ear Hear, 2000.PMID 11059700
- [6]Watkin PM; Baldwin M Identifying deafness in early childhood: requirements after the newborn hearing screen. Arch Dis Child, 2011.PMID 21047829
- [7]Vos B; Noll D; Whittingham J; Pigeon M Cytomegalovirus - A risk factor for childhood hearing loss: A systematic review. Ear Hear, 2021.PMID 33928914
- [10]Rosenfeld RM; Shin JJ; Schwartz SR; Coggins R; et al Clinical Practice Guideline: Otitis Media with Effusion (Update). Otolaryngol Head Neck Surg, 2016.PMID 26832942
- [12]Paradise JL; Feldman HM; Campbell TF; Dollaghan CA; et al Effect of early or delayed insertion of tympanostomy tubes for persistent otitis media on developmental outcomes at the age of three years. N Engl J Med, 2001.PMID 11309632