I gave birth three months ago to our second daughter. She underwent a hearing test in the hospital where she was born, and we were told everything was fine. But since then we have paid attention that she doesn't react very much to noise. At our Tipat Halav [well-baby] station, the nurse made noises behind her and saw she didn't move her head toward the noise. We did this too at home and saw the same. We took the baby to an ear-nose-and-throat specialist who said it seemed she had "liquid" in her ears and gave us drops to put in her ears for five days. We haven't noticed much change. We do not have any genetic hearing problems in our families. Should we take her for a hearing test? If the hospital test came out fine, could she still have a hearing problem? M.I., Petah Tikva
Haya Levi, a senior audiologist and communications specialist and director of the speech and hearing center at Hadassah University Medical Center in Jerusalem's Ein Kerem, comments:
If your daughter passed the test in the hospital, she probably doesn't have inner ear deafness. In this test, a small ear probe containing a microphone is placed in the ears. When the instrument makes a clicking sound, the microphone collects the ears' response. Babies for whom there is the slightest concern are recommended for a repeat test.
Fluid in the middle ear - usually - is very common among newborns, babies and young children, it can go away by itself or with treatment. From birth to three months, developmentally normal-hearing newborns do not turn their heads when they hear noises. They are startled or jump when there is a sudden noise; they move about, wake up or cry when someone talks or makes a noise.
Between three and six months, they turn their eyes only toward an interesting sound, seem to listen and awake easily to sound. Only between six months and a year do they turn their head to soft sounds, understand "no" and "bye-bye" and begin to copy speech sounds.
At the end of the treatment (drops), return to the ENT specialist and ask for a behavioral hearing test at a hearing center.
I am a woman 80 years young, in relatively good health. I continue in my profession, though I avoid stress and exercise regularly. My doctor tells me my weight is normal. My blood pressure tends to be low. I know I should be grateful for all this. However, I am still conscious of my appearance. I am much bothered by my dropped eyelids that cover my eyes as well as the pockets under my eyes. Can this be dealt with at any age? If so, where do I turn? M.H., Jerusalem
Veteran Jerusalem dermatologist Dr. Julian Schamroth replies:
Excess skin or "hooding" of the upper eyelid (known to doctors as dermatochalasis) is a common condition in the elderly. As part of the aging process, the collagen and elastic fibers in the skin degenerate and lose their elasticity. Gravity then drags this loose, lax skin downward. Although this occurs in all skin, it is most marked in very thin skin, such as that constituting the eyelids.
Although genetic factors play a part in the development of this condition, chronic sun exposure and smoking may also be exacerbating factors. The condition is harmless, but in severe cases it may interfere with vision, a condition known as ptosis. It is not associated with any underlying disease.
The treatment is usually blepharoplasty, a simple procedure done by plastic surgeons in which the excess skin is removed. Although blepharoplasty is a stand-alone procedure, it is often done in conjunction with other procedures such as a face-lift, to enhance the general appearance of the face. The procedure can be done on an out-patient basis, or might require, at most, a one-day hospital stay. It can be done under local or general anesthetic - depending on the surgeon's preference. The cosmetic results are excellent.
There are some other treatments available such as laser resurfacing of the eyelids and chemical peels, but I am not sure how successful these procedures really area.
If you have ptosis, the procedure is likely to be covered by your health fund. If not, it is a strictly cosmetic procedure, and would have to be paid for privately.
Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to [email protected], giving your initials, age and residence.