Assesment of Hearing Deficits in Children with Down Syndrome: A Comparative Cross Sectional study

Fidha Parvez Khan, F (2020) Assesment of Hearing Deficits in Children with Down Syndrome: A Comparative Cross Sectional study. Masters thesis, Madras Medical College, Chennai.


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BACKGROUND: Children with hearing loss, who have special needs make up a large proportion of the paediatric population which are hearing impaired. The underlying cause for the sensorineural loss could be due to low birth weight, low Apgar score, hyperbilirubinemia, ototoxic medication and mechanical ventilation, but conductive deafness is most commonly seen. Down syndrome, also known as trisomy 21 is a genetic disorder, that occurs due to the presence of all or part an extra chromosome 21. It is associated with a delay in physical growth and mild to moderate intellectual disability. Ear, nose, and throat (ENT) complications cause a lot of morbidity in Down syndrome. They may be inextricably linked with CNS problems, which may cause speech and communication disorders. Deafness is very frequent, and most the of the children have a conductive hearing loss. This is most probably caused by otitis media with effusion (OME). Early and persistent hearing loss in this vulnerable age group may lead to difficulties in listening, communication, behaviour and learning and perception skills. Intervention options for hearing loss associated with OME include ventilation tubes (grommets) and hearing aids. Also common causes of deafness are the effect of anatomical malformations, like eustachian tube abnormalities, persistent mesenchymal tissue in the tympanic cavity, stenotic ear canals, external auditory meatus stenosis and mastoid bone hypoplasia, ossicular chain and cochlear malformation and impacted wax. The Eustachian tube function is additionally compromised due to an anatomically constricted nasopharynx together with adenoid hypertrophy. Hence hearing in these children is assessed using pure tone audiometry and Auditory brainstem response. AIM OF THE STUDY: 1. To ascertain the value of Pure Tone Audiometry and Auditory Brainstem Response in children with Down syndrome. 2. To see if these tests can be included in the routine screening of children with Down syndrome. 3. Detection of hearing deficits such as early onset presbycusis can lead to early intervention which may improve their quality of life. OBJECTIVES: 1. Using Pure Tone Audiometry to measure the auditory threshold of the child. 2. Using Auditory Brainstem Response (ABR) to assess the retro cochlear region by way of eliciting brainstem potentials in response to audiological click stimuli. 3. Using these tests, in combination with otological examination to diagnose the degree and nature of (conductive, mixed, sensorineural) hearing loss, in comparison with age and sex matched controls of the normal population. MATERIALS & METHODS: It is a comparative cross sectional study consisting of thirty children with Down syndrome as subjects in the age group of 5 to 15 years and another thirty subjects of the same age group from the normal population. Pure tone audiometry and ABR were used to determine the hearing sensitivity of the children, and compared with age and sex matched controls. RESULTS: 60 ears were examined in both the study group and the control group. All the children underwent otoscopic examination and cleared of any cerumen in the canal. Comparing PTA between study group and control group, the p value was < 0.0001. The values of amplitudes of waves I to V and interpeak latency I - III showed no significance suggesting there is no significant sensorineural component to the hearing loss. But the interpeak latency of waves III - V showed significantly increased values in the study group and the interpeak latency of waves I - V showed a very significant increase in the study group compared to the control group. CONCLUSION: From this study it can be demonstrated that the children with Down syndrome are more prone for deafness compared to normal peers. The type of deafness appears to be conductive type rather than sensorineural. It is important to identify any hearing loss at a young age in the children so that they can receive better treatment and health care.

Item Type: Thesis (Masters)
Additional Information: 201715002
Uncontrolled Keywords: Down syndrome, pure tone audiometry, ABR, BERA, conductive.
Subjects: MEDICAL > Physiology
Depositing User: Subramani R
Date Deposited: 30 Jan 2021 16:39
Last Modified: 01 Mar 2021 03:30

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