An 8- year old boy presented with a history of mumps, which happened 6 months prior but resolved completely. Around the same time caretakers noticed progressive declined in his response to his name and instructions. This was attributed to spiritual forces, so was not sent for medical care.
By the time child presented to a general physician and was referred to an ENT specialist, he could not hear at all but speech was normal.
Physical examination showed normal ear, nose and throat except inability to perceive sound.
OtoAcoustic emission (OAE) done – failed in both ears, indicating damage to outer hair-cells.
Tympanometry showed Type A tympanogram in both ears ( normal middle ear pressures).
Pure Tone Audiometry ( PTA) showed bilateral profound hearing loss.
A trial of BTE hearing aid showed remarkable response to pure tones presented to both ears.
Parents were counselled to procure Hearing Aid and also to plan for possible cochlear implant.
How does mump virus cause hearing loss in children?
Mumps virus can cause hearing loss in children through several mechanisms:
Direct Viral Invasion
- Viral replication: The mumps virus replicates in the inner ear, specifically in the cochlea and vestibular apparatus.
- Damage to hair cells: The virus damages the hair cells in the cochlea, leading to permanent hearing loss.
Inflammation and Immune Response
- Inflammation: The immune response to the mumps virus causes inflammation in the inner ear, leading to damage to the delicate structures.
- Cytokine release: The release of cytokines, such as tumor necrosis factor-alpha (TNF-alpha), contributes to the inflammation and damage.
Pathological Changes
- Cochlear damage: The mumps virus can cause direct damage to the cochlea, leading to permanent hearing loss.
- Vestibular damage: The virus can also damage the vestibular apparatus, leading to balance problems and vertigo.
Risk Factors
Prevention
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