Case report: An unusual case of infantile hearing impairment

Introduction Conductive hearing loss is a common reason for children and their parents to see an ENT specialist. Secretory otitis media, ear drum perforations and sometimes cholesteatoma represent the main causes for these consultations. In august 2019,a five-year-old girl presented in our clinic with a left-sidedhearing loss,which according to her parents wascongenital.

Case description We took an anamnesis and performed a clinical examination as well as audiological diagnostics. Microscopic examination of the ears showed no pathologies. The tone audiogram revealed a left-sided mixed hearing loss with an air-bone-gap up to 40 dBHL at 0.5 kHz andbone conduction thresholds of 45 to 50 dBHL between 0.5 and 4 kHz, including a 70 dBHL notch at 2 kHz. The right ear was within normal limits. During exploratory tympanoplasty, otosclerosis was identified as the cause of the hearing loss and a stapes prosthesis was inserted. On the 7th postoperative day, the ear canal tamponade was removed and a pure-tone audiogram showed a decrease of the air-bone-gap down to 5 to 15 dBHL,as well as almost normal bone conduction thresholds of 5 to25 dBHL between 0.5 and 4 kHz.

Discussion and conclusion Due to the young age of our patient, we elected to forgo a preoperative CT-scan,although this could have given the first hint regarding the subsequent diagnosis. Nevertheless, this technique does not enable confirmation or exclusion of adequate ossicular function. Furthermore,it is important to consider otosclerosis as a potential differential diagnosis also in younger patients, especially since this process could be obscured by a simultaneous secretory otitis media.

Publication History

Article published online:
10 June 2020