The main causes of deafness in children are as follows: 1. Syndromic deafness: Common syndromic deafness in clinical practice includes large vestibular aqueduct syndrome, Usher syndrome, Alstereum syndrome, and Waardenburg syndrome mentioned in the previous case. These children often present with a group of clinical manifestations in different organs of the body, including deafness. Waardenburg syndrome is one of the common clinical causes of syndromic deafness and is inherited in an autosomal dominant manner, with at least 2% of congenital deafness being caused by Waardenburg syndrome. Waardenburg syndrome is characterized by a syndrome of abnormal neural crest cell function due to the absence of melanocytes of neural crest origin, and is characterized by sensorineural deafness and pigmentary abnormalities, the latter including iris heterochromia, white forehead hair, early gray hair, hypopigmentation or freckling of the skin. Other manifestations include ectopia, high and wide nasal roots, hirsutism, unibrow or mid-brow flushing. Treatment may include hearing aids or cochlear implants, depending on the degree of deafness, and may yield certain results. The Cochlear Implant Center of the Department of Otolaryngology and Head and Neck Surgery of the PLA General Hospital has successfully implanted cochlear implants in more than 1300 cases of severe deafness, including a large proportion of children with syndromic deafness, with clear results. 16 children with Waardenburg syndrome have undergone cochlear implant surgery in our department and have achieved good auditory speech rehabilitation. Prenatal diagnosis may prevent the birth of some children with syndromic deafness. Drug toxicity: Several studies have shown that ototoxic drugs are now one of the leading causes of hearing impairment in children. The main drugs that cause deafness include aminoglycosides, salicylates, antineoplastics, and alcohol. Some of these drugs include streptomycin, dihydrostreptomycin, neomycin, kanamycin, gentamicin, vancomycin, viomycin, tobramycin, balomycin, polymyxin B, quinine and aspirin. Coping strategies: Some drugs that damage the fetal inner ear should be banned by the mother during pregnancy (especially within the third month of pregnancy). For example, streptomycin. When ototoxic drugs must be used, they should be closely observed. Pay special attention to the presence of tinnitus and dizziness. Do early detection and take early measures. 3. Deafness caused by physiological structural characteristics of the ear in young children: When young children catch a cold or flu, suckle milk in a flat position or become nauseous or vomit, it often causes bacterial infection in the middle ear cavity and acute suppurative otitis media. When the pus in the middle ear cavity keeps increasing, the child will cry out due to increased ear pain. The pressure of the increased pus in the middle ear cavity can also cause perforation and rupture of the eardrum. If the child does not seek medical attention or is not treated thoroughly, chronic suppurative otitis media will result, causing the eardrum to be continuously damaged. The perforation will become larger and larger, and the impact on hearing will become more and more severe. Response strategy: Acute otitis media is an acute purulent inflammation of the middle ear mucosa. When the inflammation in the pharynx and nose spreads to the eustachian tube after a cold, pathogenic bacteria invade the middle ear and cause otitis media. The common pathogenic bacteria are mainly pneumococcus and Haemophilus influenzae, etc. Therefore, preventing colds can reduce the chance of developing otitis media. Improper nose blowing can also lead to otitis media. Some people tend to use two fingers to pinch both sides of the nose when blowing their nose. Forcefully blowing the nose out. This method of blowing the nose not only does not completely blow the nose, but is also very dangerous. Nose snot contains a lot of viruses and bacteria, and if both nostrils are pinched. Then the pressure forces the snot out toward the posterior nostril and reaches the eustachian tube, causing otitis media. The correct way to blow the nose. Is to use your fingers to press one side of the nostril, slightly force outward to blow the nasal snot from the opposite nostril, and then blow the other side with the same method. 4, noise: compared to adults, children are more vulnerable to noise. And in the absence of any pain, their hearing gradually decreases. This is due to the fact that high decibel noise over-stimulates the children’s inner ear in a weak but very sophisticated “sense receiver”, once the “receiver” is damaged, it can no longer transmit the sound to the brain. Strategies: Avoid exposing your child to long periods of time in a noisy environment and avoid common sources of noise pollution, such as television or loud stereos. 5. Peri-aural lesions: Lesions in the neighboring organs around the ear, sometimes involving the middle ear cavity, can cause hearing loss. For example, rhinitis, paranasal sinusitis, tonsillitis, adenoid hypertrophy, etc. Adenoid hypertrophy is an extremely important factor in the etiology of conductive deafness in children. Pathological hyperplasia of the adenoids due to repeated inflammatory stimulation can block and compress the pharyngeal orifice of the external eustachian tube causing secretory otitis media, resulting in conductive deafness and tinnitus, leading to hearing loss in children. If the treatment is not timely and the otitis media is too long, the hearing will not return to normal even after the adenoids are removed. Therefore, pediatric adenoid hypertrophy deserves attention once it affects the general health or adjacent organs. Response strategy: When such diseases are found, parents should take their children to the hospital for timely treatment and should never take them lightly. 6. Ear trauma: The causes include: when the child is naughty, some parents give the child a few slaps in anger; during festivals, firecrackers suddenly explode in the child’s ears, causing a huge wave of air to hit the eardrum in the ear canal; when swimming, the child’s side of the ear hits the water surface first. All of these traumas can cause rupture and perforation of the eardrum, directly resulting in hearing loss. Strategies: You can’t pull or hit the ear. You should not put beans, small balls or other items in the ear. When setting off firecrackers for the holidays. Parents should tell their children to stand far away. To avoid damage to the child’s eardrum from the explosion of gas. 7. Viral infections: Mumps complicates sensorineural deafness, mostly in preschool and school-age children, and is one of the common causes of unilateral sensorineural deafness in children. Hearing tests in children with mumps-induced deafness are more common in children with very severe and total deafness in one ear, followed by partial hearing loss in one ear and less common in both ears. The typical clinical presentation is hearing loss about 4 5 d after the onset of mumps, accompanied by vertigo and tinnitus. Response strategy: Early comprehensive treatment of childhood mumps with sensorineural deafness should be followed. Treatment measures include antiviral, improvement of inner ear microcirculation, nerve nutrition, and hyperbaric oxygen. 8. Congenital developmental malformations of the ear: These include congenital developmental malformations of the auricle, external auditory canal, middle ear, and inner ear, which can cause conduction deafness and sensorineural deafness to varying degrees. Inner ear malformations are one of the common causative factors of congenital sensorineural deafness in children. Inner ear malformations include bony malformations, membrane malformations, and abnormalities at the cellular level. Response strategy: CT and MRI of the temporal bone are particularly important in the process of confirming the cause of deafness in children. Identification of the etiology of deafness in children is important for the selection of treatment options, especially for the prognosis, contraindications to surgery, and the choice of device for artificial hearing implants. Cochlear implantation is the best treatment for severe sensorineural deafness due to congenital inner ear malformation, and other auditory implantation devices such as vibro-acoustic bridge (VSB) and bone-anchored hearing aid (BAHA) can be chosen according to the nature and degree of deafness of the child. The audiological implant team led by Prof. Yang Shiming, the head of our department, has done a lot of exploration and selection of indications in the early stage of the surgery, and has successfully operated on dozens of patients by Prof. Yang himself.