Controversies in Screening for Middle Ear Disease and Hearing Loss in Children

Abstract

GOALS —Charles D. Bluestone, MD, and Thomas J. Fria, PhD The goal of this Workshop was to assemble experts in pediatrics, infectious disease, otolaryngology, epidemiology, audiology, and biostatistics to assess the current status of screening for otitis media in infants and children. The need for such a Workshop has become increasingly apparent with the advent of the widespread use of tympanometry as a case-finding method and the controversies that have surrounded these proliferating screening programs. Specifically, the objectives of the Workshop were to (1) review the state of our knowledge of middle ear disease in children in terms of its epidemiology, diagnosis, management, complications, and sequelae, all of which pertain to the justification for screening; (2) review the epidemiologic basis of screening and relate these to otitis media; (3) review current viewpoints on screening for middle ear disease from professionals in the field; (4) review the current status of screening programs in the United States; (5) attempt to reach concensus as to the target population to be identified by screening and the most appropriate and reasonable method for screening and referral; and, (6) make recommendations as to the best manner in which to resolve the remaining controversial issues. In addition to the above named specialists, representatives from federal funding agencies and from screening instrument companies were present in an ex officio capacity. A summary of the discussions is presented here. INCIDENCE, PREVALENCE, AND NATURAL HISTORY OF OTITIS MEDIA —Margaretha L. Casselbrant, MD Otitis media is one of the most common diseases of childhood and, thus, has important economic and health care implications in society.