Dr. Yogesh Parashar

SSHL is not like any other normal hear-loss trouble. Rather it is quite a severe condition. Sudden deafness can occur at any time due to several reasons. This trouble does not affect both the ears rather only one specific ear is usually affected, and thus this is one of the prominent signs that can help the doctors to understand that SSHL has occurred. 

What are the leading causes of this hearing loss?

1. Head injury: If you have faced any severe kind of head injury ever, then it might bring SSHL. This is why you are suggested to get necessary treatment on time so that this kind of hearing loss can be avoided.
2. Loud-noise exposure: If your ears are exposed to louder noises or sounds in a consistent manner, then there is a greater possibility of the occurrence of this hearing loss. Thus, you should stay away from unwanted noises. 
3. Ageing: With the increase in age, hearing power slowly decreases. However, if you take proper precautions from the very beginning, then SSHL can be definitely avoided. 
4. Blood-circulation troubles: Interrupted blood-circulation creates different physical troubles out of which hearing loos is one of the most prominent one. And if timely treatment is not provided, then it might get converted into SSHL. 
5. Ototoxic medication: This kind of medication should not be continued for long without doctor's prescription otherwise SSHL might occur. 
6. Lyme disease: This is a kind of disease, which occurs due to tick bites and this is pretty infectious in nature. Apart from that, this disease is now considered as one of the main sources of SSHL. 

How to evaluate this hearing loss? 

1. History analysis: The history of the patient needs to be known first otherwise SSHL cannot be perfectly treated. If the history shows that the patient already has an existing trouble of ear loss for which SSHL has been proven, then in accordance with the same the treatment can be prescribed. 
2. Laboratory and imaging: Laboratory analysis is one of the main methods for evaluating SSHL and necessary images of the ears boost the potentiality and importance of this kind of analysis to a great extent. 
3. Quick evaluation: This kind of medical evaluation is mainly made on the basis of the symptoms. The doctors often follow the signs thoroughly in order to determine as to whether the patients have SSHL or not. This evaluation is highly supported by different medical tests that are prescribed by the doctor.

Valvar aortic stenosis, commonly called aortic stenosis, is a disorder which occurs when the aortic valve of the heart becomes narrow (know Main Indicators of a Heart Disease in a Child). The narrowing of the valve prevents its full opening, and hence, blood flow from the heart to the aorta is restricted. When the aortic valve gets obstructed, the heart has to exert much more effort to pump the blood. The heart muscles get weakened as a result. This condition is more common in children.

Diagnosis of Valvar Aortic Stenosis:
Before diagnosis, we should know about the symptoms of valvar aortic stenosis in children. They include:

• Feeling breathless
• Angina or chest pain with a feeling of pressure or tightness
• Syncope of fainting
• Palpitations and enhanced heartbeats
• A steady decline in regular activities and energy levels
• Fatigue due to little exertion
• Not gaining weight
• Poor eating patterns
• Problems in breathing

The wall of the left ventricle also thickens muscularly, and the thick wall occupies more space in the lower chamber of the heart and hence, the room for adequate blood supply is reduced. This may lead to heart failure.

Echocardiogram: The initial test that is recommended for patients with symptoms of valvar aortic stenosis is Doppler Echocardiography. This test enables the doctor to estimate the aortic valve region, peak or mean transvalvular gradients and the maximum aortic velocity. These primary measures are required to assess the severity of the disease. Echocardiography provides important information on the valve function, left ventricular filling pressure and disruptions in other valves.

Other major tests which help in the diagnosis of valvar aortic stenosis include:

• MRI or magnetic resonance imaging, which provides images of internal body structures with great detail.
• CT scan or computed tomography where three-dimensional images are extracted.
• Chest X ray
• Cardiac catheterization where a dye is used to highlight blockages, if any, in the heart.

Treatment: Usually, there are no medicines for fixing valvar aortic stenosis as the disease is not reversible. Medicines can be used to treat the problems, which are caused by the condition.

Replacement of the damaged valve by surgery is the best treatment for valvar aortic stenosis. The surgery performed is called valvuloplasty. This is a cardioscopic surgery where a tube with a small balloon is inserted into a vein. The tube is guided into the heart, and the balloon is inflated. The balloon and tube are removed after the valve is opened. The damaged valve is replaced by mechanical valve or the valve of a cow or pig by an open-heart surgery.

Valvar aortic stenosis is a severe heart condition in children, and the only permanent remedy for this disease is a valve replacement surgery.