The Profile of Hearing Impairment in Infants and

Children at Dr. Moewardi Hospital Surakarta

Novi Primadewi, Dewi Pratiwi, Donny Hendriyanto

DEPARTMENT OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY

FACULTY OF MEDICINE SEBELAS MARET UNIVERSITY/ DR MOEWARDI HOSPITAL
SURAKARTA - INDONESIA
2019
 Introduction
 The incidence of hearing impairment in infants and children
increases every year.
 In USA : 1.800 – 12.000 babies are born with permanent
hearing impairment.
 Bilateral permanent hearing loss

 1,33 / 1000 live births

 2,83 / 1000 elementary school children

(Chi, 2014; Korver et al, 2018)

 More frequent in babies with risk
factors 2 – 5 %
HEARING
IMPAIRMENT IN
INFANTS AND
Congenital Sensorineural Hearing Loss
CHILDREN

Both ears from severe to very

severe

(Brookhouser, 2010)
 Hearing Speech, Social,
impairment in Cognitive and Early detection
infants and Academic
children developments and Intervension
 Congenital Sensorineural Hearing Loss

 Impaired Hearing :
Impaired hearing function but still able to communicate
with or without hearing aid.

 Deaf :

Impaired hearing function unable to communicate

although with hearing aid.

(Chi, 2014)
Ethiology

(Smith, 2005)
(Krug et al, 2016)
 American Joint Committe on Infant
Hearing Statement (JCIH)

At the age of 0 - 28 days :

 Family history of congenital deaf.
 Head and neck anatomical abnormalities.
 Congenital deaf syndrome.
 Prenatal TORCH infection.
 Birthweigh of < 1.500 gram.
 Severe asphyxia.
 Bacterial meningitis.
 Hyperbilirubinemia.

 Ototoxic drug administration.

 On ventilator for more than 5 days.

(Chen, 2016)
 Auditory Development

0 - 4 months old Limited auditory ability (Reflexes Moro, Startle, Aurapalpebra)

4-7 months old Turn the head towards the sound, horizontally & inconsistent

7-9 months old Identify the source of sound to side and downward

9-13 months old Eager to find the source of sound from the bottom side

Instantly able to find the source of the sound from the sides,
16-21 months old
the bottom and the above

21-24 months old Able to localize sound from all directions quickly

2 year old The examiner must be more detailed

 Speech Development

SUSPECTED speech disorder, if :

 12 month old : Unable to babble or to copy sound.

 18 month old : Unable to say one meaningful word.

 24 month old : < 10 words of vocabulary.

 30 month old : Unable to say two words.

 Gold Standar Examination

 Oto Accoustic Emission (OAE)

 Brain Evoked Response Auditory (BERA)

 Auditory Steady-State Response (ASSR)

Quick, Easy and Non-invasive

Sensitifity : ~ 100%

(Korver et al, 2018)

Oto Accoustic Emission
Brain Evoked Response Auditory
Auditory Steady-State Response
 Habilitation
Hearing Aid
 Can be used for all ages.
 Appropriate for most of hearing impairment types.
 Can be used for 5 years and can be reprogrammed if there is
any change in hearing.
 Cochlear Implant

 Give sound access to children with severe hearing impairment

who do not get benefit from hearing aid.

 Recommended for children ≥ 12 months old.

 Has specific criteria for a candidate.

(Chen, 2016)
Auditory Verbal Therapy

(Jones et al, 2014)

Listening – Speaking – Talking
THE PROFIL OF HEARING IMPAIRMENT
IN INFANTS AND CHILDREN
AT DR. MOEWARDI HOSPITAL

1 January 2017 - 31st December 2018

 Visit to ENT Outpatient Clinic
500
450
400
350
347
300
250
200
150
155
100
50
0
2017 2018
Year
 Age Group Distribution

Age Total Percentage (%)

< 2 years old 291 57,9

2-5 years old 152 30,3

> 5 years old 59 11,8

TOTAL 502 100

 Oto Accoustic Emission

180 Patients
PASS
REFER 35,8 %
64,2 %

322 Patients
 Risk Factor Distribution
30

25 23.9
20.8
20
%
15 12.4 12.1
10
6.8
4.9
5 3.7 2.8 2.5 1.8 1.5 1.2 1.2 0.9
0
 Brain Evoked Response Auditory

250

200
200

150

103
100

50
19

0
Moderate SNHL Severe SNHL Very Severe SNHL
 Auditory Steady-State Response

164
163
162
161
160
159
158
157
156
155
95 - 110 dB > 110 dB
 Conclusion

The congenital hearing impairment in infants and

children mostly causes by undefined causes

So, need promotive and preventive efforts

to prevent the incidence of the congenital hearing
impairment on the high risk baby
THANK YOU