The Medical Consumer's Advocate
Hypoacusis (hearing loss) in adolescents
Q:
I want
to know about HYPOACUSIS IN ADOLESCENTS because I am
going to perform a conference about that. I am a
pediatrician interested in that theme.
At the end of this particular web
page, I have listed a differential diagnosis for hearing
loss. The list is not specific for adolescents, however.
Some specific comments on
adolescents:
1. Many adolescents have the same
sorts of problems with Eustachian tube dysfunction as do
smaller children. Essentially, there is a small subpopulation
of infants and children with Eustachian tube dysfunction who
never outgrow their problem. They become adolescents with
this problem, then adults with the same problem. Sometimes,
this is related to allergy, chronic sinusitis, or some other
well-established medical problem, such as an
immunodeficiency. Occasionally one can clearly blame anatomic
factors (for example, a patient with a cleft palate or other
craniofacial anomaly.) More often than not, there is no clear
reason for their persistent Eustachian tube dysfunction.
2. Many forms of genetic hearing
loss (all of which are rare, by the way) are notable for the
fact that the hearing loss begins some time during the first
two or three decades of life. I would suspect this in an
adolescent with an unexplained sensorineural hearing loss who
also had a family history of hearing loss, in which the
family member(s) also lost hearing early in life. Of course,
with recessive deafness this may be difficult to suspect,
unless there is a history of consanguinity. And, of course,
new mutation is always a possibility.
3. As with adults, teenagers have a
bad habit of mistreating their ears. Head trauma (which can
cause conductive hearing loss, sensorineural hearing loss, or
both), noise trauma (sensorineural hearing loss), ear canal
or eardrum trauma (from cleaning ear wax with inappropriate
instruments) are all common. (I also knew a young man who had
placed a rock of crack cocaine in his ear canal to hide it.
He was Hispanic and kept calling it "piedrito",
which with my so-so ability with Spanish, I thought he was
saying "little rock." I was lecturing him on the
fact that he was way too old to be putting little rocks in
his ears when my Hispanic medical assistant politely informed
me that my patient had put cocaine in his ear canal!) While
we are on the subject of ear foreign bodies, in some
populations, insects are very common. During my residency,
cockroaches were by far the most common ear foreign body in
young adults.