26 February 2019
By: Shefali Shah
As you take your baby or young child through several appointments in Audiology, you are anxious to complete the testing procedure and obtain diagnostic information on the degree and type of hearing loss. You may well be dismayed that appointments are cancelled every time your child develops a cold. Given that the average child has approximately 8-10 colds by the age of 2 years, (Source: healthychildren.org), or that your child’s medical history makes him or her especially susceptible, colds can test your patience!
What connection do colds have to your child’s hearing levels?
The reason for this connection between colds and hearing loss is that anatomically, our nose is connected to our ears. The human ear consists of three parts: the outer ear, the middle ear and the inner ear. A thin tube-like structure connects the middle ear to the nose and throat. This tube is called the Eustachian tube. The main function of the Eustachian tube is to equalise pressure in the middle ear.
A cold is a viral or bacterial infection caused by rhinoviruses or invisible droplets in the air that we breathe or that we come into contact with, when we touch objects that carry this infection. This creates a liquid secretion of mucous from the nose, creating a runny nose. When your child gets a cold, this mucous secretion from the nose, may cause the Eustachian tube to become swollen and get blocked. That is why we experience a sensation of blockage or fullness in our ears, when we have severe colds. Your baby experiences this discomfort too but being too young to express his or her experience, becomes fretful and cranky. Swollen and/or blocked Eustachian tubes can no longer equalise pressure in the middle ear space.
As the cold progresses, the pressure in the middle ear may drop, building up negative pressure which causes the accumulated mucous (fluid) to fill in the middle ear space, creating the sensation of ‘blocked ears’. This accumulation of fluid reduces the sound travelling to our ears from the external environment, creating a temporary hearing loss. For your deaf child, this temporary hearing loss adds to the existing hearing loss, demonstrating inaccurate hearing levels because it reflects hearing difficulty that is worse than what your child actually has. This is why your child’s audiologist will re-schedule an appointment if your child reports with a cold.
As the cold passes, the fluid recedes, the blockage and other ear related symptom abate and hearing returns to its pre-cold levels. Resuming the testing procedure will now yield accurate hearing levels for your child.
Treating colds in babies and young children
You are best guided by your child’s paediatrician in the line of treatment and the choice and dosage of medication to treat your child’s cold. Allowing your child to get a lot of rest at this time, helps the body fight the infection.
The most common type of ear infection in children that infects the middle ear, is known as Acute Otitis Media (AOM) or Glue Ear. Glue ear is a common condition in children, where the middle ear fills with fluid. Glue ear may be caused by frequent colds. The infection travels to the middle ear, makes it swollen, creating a sticky secretion or discharge that slows down the movement of the ear drum and the 3 tiny bones in the middle ear, and may cause difficulty in hearing, accompanied by severe ear-ache. Do not ignore these symptoms. Request your paediatrician to refer you to a Paediatric Ear Nose Throat Consultant (i.e. a Paediatric ENT) and a Paediatric Audiologist to get your child’s ears and hearing checked.
For some children, the infection persists and the symptoms do not resolve. Some middle ear infections can be recurrent (i.e. the infection returns after treatment has concluded), because the middle ear fluid neither drains on its own nor with medication.(refer https://cks.nice.org.uk/otitis-media-acute). Therefore, a Paediatric E.N.T may recommend treatment using grommets. Tiny tubes called grommets, are inserted surgically into the eardrum in order to drain the middle ear fluid. Your child’s Paediatric Audiologist will conduct audiological evaluations (such as an audiogram and immittance audiometry) pre- and post- grommet insertion to evaluate the middle ear status of your child and to help you understand your child’s levels of hearing and to monitor them over time.
Recurrent colds, Glue ear and ear infections managed and treated effectively and in a timely manner, will allow your child to listen, learn and talk like other children of the same age.