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      The Prevention of Noise Induced Hearing Loss in Children

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      Author(s): *
      Publication date (Electronic):
      Journal: International Journal of Pediatrics
      Publisher: Hindawi Publishing Corporation

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          Abstract

          Increasingly, our acoustic environment is filled with amplified sound sources (e.g., MP3 players, video game stations, and sports/entertainment venues). There is serious concern and also some controversy about the risks of acoustic trauma in children. This overview provides some basic information on the physiological mechanisms that lead to noise induced hearing loss, a survey of various studies that, on balance, indicates that there is cause for concern, and finally a discussion on measures that can help to prevent noise induced hearing loss in children. This paper is designed for public health and other healthcare professions (ENT, audiologists, family doctors, and pediatricians) who should understand the risks of noise induced hearing loss and its prevention.

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          Cross-links between stereocilia in the guinea pig organ of Corti, and their possible relation to sensory transduction.

          J.O. Pickles, S.D. Comis, M.P. Osborne (1984)
          Hair cells of the guinea pig cochlea were preserved for electron microscopic examination by fixing in glutaraldehyde without the use of osmium. An extensive array of cross-links was seen between the stereocilia, by both scanning and transmission electron microscopy. The stereocilia were linked together laterally, particularly near their apical ends, by links running approximately at right angles to the long axis of the stereocilia. One set joined stereocilia of the same row, and another set joined stereocilia of the different rows, holding the tips of the shorter stereocilia in towards the longer stereocilia of the next row. In addition, the tip of each shorter stereocilium on the hair cell gave rise to a single, upwards-pointing link, which ran up to join the taller stereocilium of the next row. We suggest that distortion of this link would give rise to sensory transduction. On this basis, we are able to explain the V shape of the rows of stereocilia on outer hair cells. Within the rows, the three-dimensional arrangement of the stereocilia was different from that seen conventionally. Rather than standing parallel, the stereocilia of the different rows tapered in together at the tips, presumably held by the laterally-running cross-links. In addition, a membrane roughness, particularly pronounced in the region of the stereocilium which gives rise to the cross-links, was seen. However, the lateral and basal surface membranes of the hair cell, and the membranes of the internal organelles, had a more conventional appearance.
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            Estimated prevalence of noise-induced hearing threshold shifts among children 6 to 19 years of age: the Third National Health and Nutrition Examination Survey, 1988-1994, United States.

            Samuel D. Brody, DEBORAH RUBIN, E Esteban … (2001)
            This analysis estimates the first nationally representative prevalence of noise-induced hearing threshold shifts (NITS) among US children. Historically, NITS has not been considered a common cause of childhood hearing problems. Among children, NITS can be a progressive problem with continued exposure to excessive noise, which can lead to high-frequency sound discrimination difficulties (eg, speech consonants and whistles). The Third National Health and Nutrition Examination Survey (NHANES III) was conducted from 1988 to 1994. NHANES III is a national population-based cross-sectional survey with a household interview, audiometric testing at 0.5 to 8 kHz, and compliance testing. A total of 5249 children aged 6 to 19 years completed audiometry and compliance testing for both ears in NHANES III. The criteria used to assess NITS included audiometry indicating a noise notch in at least 1 ear. Of US children 6 to 19 years old, 12.5% (approximately 5.2 million) are estimated to have NITS in 1 or both ears. In the majority of the children meeting NITS criteria, only 1 ear and only 1 frequency are affected. In this analysis, all children identified with NITS passed compliance testing, which essentially rules out middle ear disorders such as conductive hearing loss. The prevalence estimate of NITS differed by sociodemographics, including age and sex. These findings suggest that children are being exposed to excessive amounts of hazardous levels of noise, and children's hearing is vulnerable to these exposures. These data support the need for research on appropriate hearing conservation methods and for NITS screening programs among school-aged children. Public health interventions such as education, training, audiometric testing, exposure assessment, hearing protection, and noise control when feasible are all components of occupational hearing conservation that could be adapted to children's needs with children-specific research.
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              Treatment of sudden sensorineural hearing loss: I. A systematic review.

              Anne Elizabeth Conlin, Lorne S Parnes (2007)
              To identify, evaluate, and review randomized controlled trials (RCTs) on the treatment of sudden sensorineural hearing loss (SSHL). A MEDLINE search and hand search were conducted to identify RCTs published between January 1966 and February 2006 in the English language on the treatment of SSHL. Search terms included hearing loss, sensorineural (MeSH term), sensorineural hearing loss (text words), and sudden deafness (text words). Prospective RCTs on the treatment of patients diagnosed as having SSHL. One independent observer extracted study data. Validity was evaluated using standard criteria. Characteristics and results were reviewed systematically. A total of 21 RCTs were identified regarding various treatments, including systemic and intratympanic steroids; antiviral and hemodilution agents; mineral, vitamin, and herbal preparations; batroxobin; carbogen; and hyperbaric oxygen. All studies used audiometric outcome measures. Only 2 studies used identical criteria to define SSHL. The method of randomization was described in 2 studies. Validity scores ranged from 2 to 8 (of 9). Positive results were reported favoring systemic steroids, intratympanic steroids, batroxobin, magnesium, vitamin E, and hyperbaric oxygen, although there were serious limitations in each study with a positive finding. There was no difference in audiometric outcomes reported across all studies of antiviral and hemodilution agents and no difference in one study of systemic steroids vs placebo. To our knowledge, no valid RCT exists to determine effective treatment of SSHL. Systemic steroids cannot be considered the gold standard of treatment of SSHL, given the severe limitations of the landmark study supporting their use.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Int J Pediatr
                Journal ID (iso-abbrev): Int J Pediatr
                Journal ID (publisher-id): IJPED
                Title: International Journal of Pediatrics
                Publisher: Hindawi Publishing Corporation
                ISSN (Print): 1687-9740
                ISSN (Electronic): 1687-9759
                Publication date (Print): 2012
                Publication date (Electronic): 13 December 2012
                Volume: 2012
                Electronic Location Identifier: 473541
                Affiliations
                Auditory Science Laboratory, Department of Otolaryngology-Head & Neck Surgery, University of Toronto and The Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada M5G 1X8
                Author notes
                *Robert V. Harrison: rvh@ 123456sickkids.ca

                Academic Editor: Joel R. Rosh

                Article
                DOI: 10.1155/2012/473541
                PMC ID: 3530863
                PubMed ID: 23304173
                SO-VID: 16eb4470-c9f9-44e9-a87e-aac0e9ad31af
                Copyright © Copyright © 2012 Robert V. Harrison.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 11 June 2012
                Date revision received : 14 November 2012
                Date accepted : 16 November 2012
                Categories
                Subject: Review Article

                ScienceOpen disciplines: Pediatrics
                Data availability:
                ScienceOpen disciplines: Pediatrics

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