Further Outpatient Care
See the list below:
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Otologist
Patients should see an otologist on an annual and as-needed basis. Systematic otologic and audiologic follow-up leads to significant findings in up to 58% of children.
Frequent findings include problems with hearing aids, diseases of the external or middle ear, and progressive hearing losses.
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Audiologist
Schedule audiologic reevaluation every 3 months during the first year and every 6 months thereafter.
Hearing aids should be calibrated periodically and new molds fitted when necessary.
Periodic audiometric testing is necessary to rule out fluctuation or progression of hearing loss.
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Speech and language pathologist
Speech and language therapy is imperative to promote proper language and communication skills.
Follow-up must also reassess the accuracy of the initial diagnosis, and appropriate modifications to the habilitative plan must be implemented. Assessment of effectiveness of the educational program is critical to follow-up evaluations.
Deterrence/Prevention
Instruct patients to avoid ototoxic medications and loud noise exposure without hearing protection.
Prognosis
With proper amplification, speech and language therapy, and educational programs, a patient with SNHL can fully participate in the totality of adult life, including social activities and work.
Patient Education
See the list below:
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Numerous educational methods are currently used for children with hearing impairment. These methods include auditory-oral training, cued speech, and total communication.
Auditory-oral training stresses acquisition of speech and language through enhancement of residual hearing. Lipreading skills, along with appropriate amplification, are heavily emphasized.
The cued speech approach is a visual-oral system that uses hand cues to supplement information received from lipreading. Hand cues alone are ambiguous, necessitating development of appropriate lipreading skills for language comprehension.
Manualism is a system of communication that stresses use of the manual alphabet (fingerspelling) and sign language for communication. American Sign Language (Ameslan) has been the language of the deaf population in the United States for more than a century. Ameslan does not follow English grammatical rules and has its own semantic system. Signed English uses syntax compatible with English grammar, giving people who are deaf knowledge of proper structure and usage of English.
The total communication method emphasizes manual, oral, and aural modes of communication. This method urges early use of residual hearing while accepting sign language as a normal means of communication. Speech and use of spontaneous expression are also encouraged.
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Educators, individuals with hearing impairment, and parents still disagree on the most advantageous method of communication. The method selected has a profound influence on a child's ability to someday fully participate in the totality of adult life, including social activities and work. No single educational program is correct for all children with hearing impairment, but, rather, decisions should be individualized for each child.
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For excellent patient education resources, visit eMedicineHealth's Ear, Nose, and Throat Center. Also, see eMedicineHealth's patient education article Hearing Loss.
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Inner ear.
