Continuing management of conductive hearing loss during language development.

Recently greater attention has been focussed on the possibility that mild fluctuating or intermittent hearing loss, as seen in one of early childhood's most common illnesses, otitis media, may have long-lasting and sometimes devastating effects on language development and learning. Conductive hearing loss in serous otitis media most affects frequencies below 2000 Hz, and the duration of hearing loss after an acute episode of otitis media may last 6-24 months in up to 30% of affected children. The first principle of management of this problem and congenital conductive hearing loss is detection prior to language delay. Special attention should be given to neurologically handicapped, retarded, learning disabled or physically frail children since their deficient speech and language are often attributed to abnormal neurologic or intellectual status. Treatment includes limited use of vasoactive decongestants; for acute suppurative otitis media antibiotics may be chosen empirically with a high percentage of good results. Other measures include speech and language evaluation, home stimulation language programs and temporary or longterm amplification. The surgeon assesses the patient for potential operability. Surgery to correct a congenital conductive lesion should not be attempted in an only hearing ear.