March 3rd is National Ear Care Day, with this year's theme being "Focus on Children's Hearing Health." Pediatric ENT specialists recommend prioritizing newborn hearing screening to detect sensorineural hearing loss—particularly bilateral sensorineural deafness—early. Prompt intervention, such as hearing aid use or cochlear implant placement, combined with early auditory stimulation, can help children achieve hearing levels close to those of typically hearing peers.
Neural Hearing Loss Requires Special Attention in Newborns
Luo Renzhong, Director of the Guangzhou Newborn Hearing Screening and Diagnosis Center and Head of the Otolaryngology Department at Guangzhou Women and Children's Medical Center, noted that in recent years, Guangzhou has seen approximately 100 new cases of deaf children annually.
Dr. Luo explained that hearing loss is categorized into conductive and sensorineural types. Data indicates that 0.3% of newborns exhibit hearing issues. However, the vast majority of these cases involve conductive hearing loss, which is temporary. Most infants regain normal hearing within 6-12 months, with only a small minority requiring intervention for recovery. In contrast, sensorineural hearing loss warrants attention and treatment.
"Unilateral hearing loss does not impair listening or speaking and may not require intervention. Bilateral sensorineural hearing loss necessitates intervention: mild cases allow speech without difficulty, though some words may be unclear, and intervention may be considered based on circumstances; moderate cases involve stuttering and require appropriate hearing aids; severe bilateral sensorineural hearing loss prevents both hearing and speaking, necessitating early cochlear implant placement."Guangzhou Women and Children's Medical Center oversees the city's newborn hearing screening program. Statistics from the past decade indicate that 5 per 10,000 newborns in Guangzhou have moderate or higher bilateral sensorineural hearing loss, requiring cochlear implants at birth.Cochlear implantation involves surgically placing an artificial electrode into the cochlea. This electrode bypasses damaged hair cells in the inner ear to directly stimulate the auditory nerve, restoring hearing to the patient.
Hearing aids or cochlear implants selected based on bilateral sensorineural hearing loss severity
Some children, unable to hear sounds for extended periods, fail to develop speech. Parents mistakenly attribute this to the saying "late talkers are gifted," delaying medical consultation. Others believe slight delays pose no issue, putting off examinations indefinitely.Luo Renzhong emphasizes that national guidelines recommend cochlear implantation before age 5 whenever medically indicated, with earlier being better.
"There's a golden period and a silver period for cochlear implantation: the golden period is under age 2, the silver period is ages 2-3. Implantation between ages 3-5 is still possible but less optimal than before age 3."Luo elaborated that under normal circumstances, sound waves cause the eardrum to vibrate, transmitting vibrations to the inner ear fluid and the hair cells' cilia. These vibrations are then converted into electrical signals transmitted to the auditory center, enabling sound perception. Before age 2, children are in a period of rapid development. If hearing impairment leads to prolonged lack of auditory stimulation, the hair cells atrophy and cannot recover."Infants possess strong plasticity. The earlier they receive auditory stimulation, the more likely they can develop like typically hearing children. While children aged five or six can regain some hearing through cochlear implants, they may struggle to comprehend what they hear," Luo emphasized. Early auditory stimulation enables children to develop language and communication skills comparable to their peers.
Newborn hearing screening is crucial, but delayed hearing loss also warrants attention. Newborns should undergo their first hearing screening between days 2 and 5 after birth. If they fail, a second screening is conducted at 42 days. If they still fail, a detailed hearing evaluation is necessary.
"Newborn hearing screening only reflects the child's hearing status at that moment. Even if they pass, parents shouldn't assume everything is fine. They must continue monitoring the child's auditory responses and language development. If any issues arise, they should bring the child to the hospital for a detailed hearing evaluation," Luo Renzhong emphasized. Some children develop delayed hearing loss, which is not uncommon.He cited the example of large vestibular aqueduct syndrome, a recessive genetic disorder characterized by progressive hearing loss after birth, typically manifesting around age 2. Caused by an enlarged vestibular aqueduct, any action increasing intracranial pressure—such as colds, air travel, diving, playing wind instruments, or breath-holding—can trigger vertigo and progressive hearing loss, ultimately leading to deafness.Once diagnosed, besides avoiding actions that increase intracranial pressure, early detection and fitting of hearing aids are crucial to ensure the child acquires language skills promptly. If hearing aids prove ineffective or yield poor results, cochlear implant surgery should be considered.
Tips: Parents should be vigilant for signs of hearing issues in children.
Parents should be alert and promptly take their child to an ENT specialist if they notice the following behaviors:
- At 3 months old, the baby shows no reaction to sudden loud noises;
- After 6 months, the baby does not turn toward sounds when heard;
After 1 year old, the baby shows no understanding of parents' speech;
At 2 years old, the baby cannot form sentences longer than two words;
Older children may exhibit sluggish responses, frequently ask others to repeat themselves, turn up TV volume excessively, show no reaction to shouting or doorbells, or even appear detached from their surroundings.