Can a 3-year-old child with an ear infection and a perforated eardrum suffer hearing loss if ear drops are given in excess?

Hello,

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Please do not worry because I know you are apprehensive about your child's hearing. The drugs which cause hearing loss are called ototoxic drugs. Many of them affect the hair cells of your inner ear. Sofradex contains Framycetin, which is an aminoglycoside antibiotic. The most common aminoglycosides that have proven ototoxic effects are mainly Amikacin and Gentamicin. Framycetin is a comparatively safer drug. You need not worry, but I understand an excessive amount of this ear drop went into your child's ear. However, most of it would have drained out as you wiped it with tissue. Also, the eustachian tube drains out the remaining drops, a natural way of draining middle ear fluids. Your child has an ear drum perforation. This will heal on its own. You will have to dry the baby's ear by placing cotton soaked in petroleum jelly.

Hello,

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I understand your concern. Please do not worry, as a single exposure for a short duration would not cause any damage to your son's hair cells. Has any hearing test been done now or before? As you said, he is visually impaired, is he suffering from some congenital syndrome? How is his response post the drug exposure? Is he responding to sounds by turning his head towards sudden sounds?

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I am glad his visual disability is non-syndromic because there are syndromes where usually hearing and vision are impaired. Yes, as you have described, he has suffered from acute suppurative otitis media (ASOM), which has caused a perforation in his tympanic membrane. Is there ear discharge still? If it has stopped, you need not continue ear drops. However, if there is ear discharge, I suggest you will have to put him on other ear drops like Ofloxacin ear drops. Consult a specialist doctor, discuss with them, and take medications with their consent. I am sure the doctor would have also prescribed some kind of oral antibiotics as well. Please continue that also. The ear must be kept dry for at least 15 to 20 days for the eardrum to heal.

Hello,

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I suggest your son to continue with the oral antibiotics. As I already said, the drops you had flooded would not be there in the middle ear. The middle ear has its way of clearing secretions via the eustachian tube, so the extra fluid would have drained through the eustachian tube into the nasopharynx. Flushing the ear whenever there is an ear drum perforation should always be avoided, as the fluid used can damage inner hair cells.

hello mam.. hows your child doing now, i mean how's his hearing and infection.. since when he's complaining of this telephone ringing in the ear? is it present at all times or only during any specific timings? as far as his hearing is good you need not worry about the ringing sensation, sometimes when the infection clears there will be slow recovery of inner hair cells , so that might also cause a temporary tinnitus.. did you visit any ent, i would advise to get a consultation as the ent examine your childs ear drum and give a better picture.. all i am concerned about is hows hearing now?

as i can see in the audiogram . left ear has a very small amount of conductive hearing loss due to middle ear effusion , as tympanogram is also suggestive of b type curve. the audiologist seems to have mentioned the right tympanic membrane is clear but your of the opinion that there's a perforation.could you substantiate? if the ringing is in the left year , the effusion in the middle ear itself can cause tinnitus and i personally dont feel its worth testing his hearing at 4khz as one of the reason for dip in 4khz is ototoxicity, there are other and many situations which can cause similar effect like exposure to loud sounds etc.. have you recently consulted any ent for the middle ear effusion? whats their opinion

yes mam if the right ear with perforation is dry you need not put any ear drops these infection of ears with ruptured tympanic membrane is quite common in children..they usually heal by themselves.. yes the tinnitus in left is likely due to the effusion in that ear as the effusion subsides the ringing should go away and hearing should also get better, and as the doc said, grommets is the next line of therapy if the effusion doesn't reduce on its own..now since the child has bilateral ear disease i would like to rule out any nasal pathologies like allergic rhinitis or adenoid hypertrophy,which usually causes eustachian tube dysfunction leading to bilateral ear disease in children, so i will ask you a few questions does your child breath normally though nose? any nasal obstruction? does he do a lot of mouth breathing? How's his breathing in sleep, does he keep his mouth open or snore a lot?any medications that have been prescribed for his effusion,like nasal drops, nasal sprays?

glad to hear that your ent has ruled out adenoid issues.. bone conduction seems to be almost normal, there's no need to check hearing at higher frequencies ,the other point being audiometry in children are not that conclusive also,as children are given mixed responses especially below 6 to 7 yrs of age. i feel waiting for effusion to reduce is the best option here and also please dont worry about ototoxicity,as the left side tm is intact any drops administered to that war wouldn't have entered the inner or middle ear ,as tm is intact. contact me anytime if you have any other queries, happy to help..

yes mam i remember very well that drops was administered to right, but your child is experiencing tinnnitus in the right ear, which has an intact tympanic membrane..so thers no way the drops which was put in right could go and cause ototoxicity in left ear.. thats what the bone conduction shows that the inner ear is working fine, and yes as your saying theres conductive hearing loss which is due to effusion.. bone conduction loss signifies sensorineural hearing loss since here its almost normal..I don't think there's ototoxcity and any sensorineural hearing loss