Sudden bilateral deep hearing loss in a child – case study

Introduction. Sudden bilateral deep hearing loss is very rare in children. Its estimated prevalence is 2% among children with hearing loss. The causes include acute acoustic trauma, vascular disorders of the inner ear, sudden viral or bacterial infection, and trauma of the inner ear. Noise is currently an important risk factor for hearing impairment. Groups that are particularly vulnerable to noise damage include children and young adults. The effects of noise include hearing impairment of different degree and the more and more commonly diagnosed extra auditory effects of noise in the form of anxiety, irritability, cognitive impairment, reduced intellectual ability, difficulty in falling asleep, circulatory disorders, hormonal disorders, and changes in social behavior. Case report. We present a case of a 9-year-old girl who experienced sudden bilateral deep hearing loss of the left ear, which was caused by a school bell during a school break. Six weeks after the sudden hearing loss in the left ear, hearing loss in the right ear of the unknown etiology appeared. The girl was in good general condition, no vertigo and balance impairment were observed. In the tonal audiometry, bilateral deep mixed hearing loss was observed. The treatment in the hospital included surgery in the form of bilateral explorative tympanotomy of the middle ear with anterior tympanocentesis and tube insertion, as well as conservative treatment: dexamethasone, vipocentin, piracetam, B vitamins, xylometazoline, and hyperbaric oxygen therapy. Hospitalization lasted 14 days. A complete recovery of hearing was achieved. Conclusion. Sudden bilateral deep hearing loss in children can be caused by an acute acoustic trauma. Studies show that noise is an important disturbing factor in the school environment and may be harmful. Noise levels of ca. 80-85 dB measured in corridors during school breaks and in sports halls may pose a risk of hearing impairment. The consequences of trauma caused by noise in children are very difficult to predict. It is important to recognize the problem early, as well as to introduce a proper diagnostic process and implement the treatment quickly, which is a key to the positive outcome. Keywords