Hearing loss as a sequel of secretory and acute otitis media as reflected by audiometric screening of Swedish conscripts

Abstract

Many authors have shown a small effect on hearing from middle ear disease even a long time after active disease has subsided. We wanted to see to what extent those who have had otitis media in childhood in our district have normal hearing at the age of 18 years. The aim of the present study is to find out if a history of secretory otitis media (SOM) up to 14 years of age or acute otitis media (AOM) up to 4 years of age affects hearing at conscription in an age cohort of Swedish boys. For a cohort of 951 boys we have good knowledge of their ear diseases up to 14 years of age from previous studies. The prevalence of elevated thresholds in audiometric screening at conscription was compared for the group of boys who had been treated with tympanostomy tubes and the group of boys with no history of ear disease. Similarly, boys with a history of ear disease but no treatment with tubes were compared to boys without history of ear disease. We also compared the prevalence of elevated thresholds for boys with a history of at least four episodes of AOM up to the age of four to those who had had no episodes up to that age. Those who had been treated with tympanostomy tubes because of longstanding SOM had a significantly higher prevalence of elevated thresholds for solitary frequencies. Two treated boys had a pure tone average greater than 25 dB, one unilaterally, one bilaterally. No difference could be seen between those who had had episodes of ear disease but no treatment with tympanostomy tubes and those who had had no documented ear disease. The prevalence of elevated thresholds was not correlated to more than three treated episodes of acute otitis media up to the age of 4 years. Boys who had been treated with tympanostomy tubes had a higher prevalence of having a hearing threshold above 20 dB for at least one frequency at the age of 18. Hearing handicap was not a common sequel to SOM. We can show no relation between more than three treated episodes of AOM before the age of four and screening results at the age of 18.