📩 02/07/2021 12:15
Gazi University Faculty of Health Sciences Department of Audiology, Head of Speech and Language Therapy Department Prof. Dr. According to Bülent Gündüz, hearing loss in children causes negativities not only in speech development, but also in cognitive, motor and psychosocial development areas.
Gazi University Faculty of Health Sciences Department of Audiology, Head of Speech and Language Therapy Department Prof. Dr. According to Bülent Gündüz, 1000 or 2 out of every 3 risk-free children born in Turkey are born with hearing loss. If hearing loss is not treated, it negatively affects children's speech development as well as cognitive, motor and psychosocial development areas.
Noting that more than 50 percent of hearing loss is due to genetic (hereditary) factors, Gündüz emphasized that genetic hearing loss is frequently encountered due to the high incidence of consanguineous marriages in Turkey. Gündüz said, “The most common causes of non-genetic hearing loss are infections such as rubella or herpes simplex virus, premature birth, low birth weight, drug and alcohol use while pregnant, jaundice and Rh factor problems, diabetes during pregnancy, high blood pressure (preeclampsia) during pregnancy and anoxia,” he said.
“Diagnosis and early intervention is required in the first 3 months after birth”
Expressing that in cases of hearing loss in children and adults, especially the group that did not pass the newborn screening and were followed up with differential diagnosis tests, Gündüz stated that the majority of the patients were not affected by auditory stimulus in the first few years of life, which is characterized as the 'sensitive or critical period' in terms of language development, especially in the pediatric group. Speech and language development is affected in children with congenital (congenital) hearing loss who are deprived of their hearing. In such cases, hearing loss should be diagnosed within the first 3 months after birth and audiological early intervention should be performed. In addition, hearing loss due to the use of antibiotics in childhood constitutes another group of children with hearing loss that is frequently encountered. In the adult group, aging-related hearing loss and sudden hearing loss are the most common types of hearing loss.
“Rehabilitation is as important as treatment”
Stating that informing and rehabilitating patients and their relatives in all aspects before the intervention in cochlear implant applications or hearing aid applications is at least as important as treatment, Gündüz states that families also have a role in this process. Gündüz said, “The application of auditory rehabilitation throughout the day by reflecting the child's daily life and routines, not only with the limited-time activities that the child receives in institutions, but also with family education, enables the process to progress much faster and ideally. If I need to talk about an example case; Our baby, who was born in 36 at 2017 weeks, was referred to be evaluated with the grade of TS newborn hearing screening, passing one ear and not passing one ear. In the hospital, the family was told that one ear could not pass due to the accumulation of fluid. Although her mother followed TS closely because she was a pre-school teacher, she thought that there was no problem until her child was 3 months old due to the misguidance of the people around her. But when he started to constantly test it with his own methods, he saw that he did not react. They came to us. After our evaluation, we put a hearing aid on our baby, who we thought had severe hearing loss, when he was 5 months old. As a result of follow-up with a hearing aid, we told the family that we thought he was a cochlear implant candidate. In addition to the support of her mother and father, our patient started to go to special education when she was 9 months old. At the age of 11 months, he started to make the sounds we call babbling, and in the later stage, words that are not understandable. But this language development would not be enough. While he was thinking about cochlear implant surgery around the age of 1, he was able to have surgery on both ears at the age of 2, when the surgeries suddenly stopped. Initially, he did not respond to sounds at all. Within 2 or 3 weeks, he started to hear. Our child's language development was determined as 3 years old in the TEDIL test when he was 5 years old.
“We recommend a cochlear implant when the hearing aid is not enough”
Gündüz said, “We recommend cochlear implantation for patients with severe and profound hearing loss who cannot benefit enough from the hearing aid. For cochlear implantation, the inner ear structures must be suitable for electrode placement and the auditory nerve must be in working condition. The communication skills of people who have inner ear and/or auditory nerve anomalies and are therefore not suitable for cochlear implants are being tried to be improved with auditory brainstem implants.
“Hearing loss due to meningitis is also covered by SSI”
Emphasizing that when severe and severe hearing loss is detected, cochlear implants are covered by SSI in both ears until they reach the age of 1 in infants and 4 years in children, Gündüz said: However, the implantation of a single ear is within the scope of SGK. Gündüz continued his words as follows: “The cost of hearing loss after meningitis is covered by the institution, provided that it meets the cochlear implantation criteria, without seeking the rule of not benefiting from the use of binaural hearing aids for a period of 4 months, if it is documented with a health board report.”