Monday, 19 September 2011

Hearing screening for babies

Hearing is one of the senses that we are blessed with from birth. However some babies are born with hearing problems. A baby's speech development is affected if his/her hearing is abnormal. Normally it is difficult for parents to tell if their baby's hearing is normal or not at birth. It only becomes apparent later when the baby does not respond to loud sounds or to their names or when they do not develop speech.

Why is it important to get the hearing checked at birth?
Hearing loss is a common disorder at birth and can affect up to 1.3 to 6 per 1000 live births. Hearing loss in a newborn baby is also a condition which cannot be seen physically. Therefore often the hearing loss is detected late. The Joint Committee on Infant Hearing states that a baby with hearing loss should have diagnostic hearing test by 3 months of age and hearing intervention no later than 6 months of age. Infants who are deaf or hard of hearing will lose out on their peers in terms of speech development, social skills, reading skills, communication skills and cognition.

How is the test performed?

Photo: A woman checking a newborn's hearingNewborn hearing screening test is done soon after birth to detect if the baby has normal hearing to develop speech. It is a simple non invasive test that needs to be done in a quiet room or even the mother's bedside when it's quiet. Usually the test is done by a professional personnel such as a trained nurse or medical assistant. A small soft ear phone is inserted into the ears during the test. The baby would hear either soft tones or clicks through the earphones. Both ears are checked separately.

What are the possible results of the newborn hearing screening?
After the test is completed the machine will either produce a 'pass' or 'refer' results. Having obtained a 'pass' means that your baby's hearing is considered normal to enable him/her to develop normal speech. Obtaining a 'refer' results means that your baby needs to have further assessment to confirm if there is a permanent hearing loss. The hearing screening does not confirm nor diagnose a hearing loss.

Further hearing assessments
If the results are 'refer', the health personnel who conducted the hearing screening test would then schedule the baby for further hearing test in a few weeks' time. These confirmatory hearing tests (Auditory Brain Stem Reflex) are non-invasive and usually done by the Audiologist in their clinic. These tests take a bit longer to perform and the baby should be asleep throughout the test.

If my baby has passed the hearing screening, will he/she have any hearing problems in the future?
The baby's hearing must still be monitored as he/she is growing up. Parents can do the monitoring at home and bring their child to the doctor's if they suspect that the hearing is abnormal. This is because the child may still develop ear problems such as  glue ear (middle ear effusion), otitis media (infection of middle ear), impacted ear wax and other ear conditions which can affect the hearing.

Newborn hearing screening is a routine test performed in most hospitals for the newborn. The hearing screening is done as part of the usual screening tests for babies to detect any congenital medical conditions. Make sure to ask your doctor about newborn hearing screening for your baby. Ensuring normal hearing for your baby can give him/her a headstart in life.

Year 2007 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs (

Photo credit

Sunday, 11 September 2011

Should the tonsils be removed?

The above question is often heard during consultation at the ENT clinic. The patient goes through a rollercoaster of thoughts when their doctor suggests an operation. What more when a parent has to make the decision on behalf of their child.

What are tonsils?

Tonsils are lymphoid tissues at the back of the throat which form a part of the immune system. It grows rapidly between the ages 2 to 6 years and then slowly regress with age. However it is not unusual for tonsils to get infected resulting in a condition called tonsillitis with symptoms of severe sore throat and fever.

When is tonsillectomy advised?
Common indications include
       Recurrent or Chronic tonsillitis; more than 3-5 episodes in a year
       Enlarged tonsils causing airway obstruction or snoring
       Suspicion of tumour; ulcerated tonsils or unilateral tonsil enlargement
       Peritonsillar abscess

How is tonsillectomy performed?
The patient is given general anaesthesia and the tonsils are removed via the mouth. At times other procedures are also indicated such as adenoidectomy depending on the patient's history and ENT examination.
Complications associated with tonsillectomy is minimal. Patients are informed of pain on swallowing and advised to take soft cold diet immediately after surgery. And return to normal diet till healing is complete. This normally takes about 7-10 days. Patients are also informed about the possibility of post tonsillectomy bleeding.

Tonsillectomy is a simple operative procedure. What is more important is the correct selection of patients. The immune function is not affected after tonsillectomy as there are other lymphoid tissue in the throat area.