Possible long-term consequences of middle ear effusion.

Abstract

Three studies will be reported in this paper and the suggestion made that there may be a connection between the findings. The first study concerns the middle ear status of 48 children treated in 1966/67 for middle ear effusion and followed up after ten years. Prior to treatment the median HL was 20 dB (SD = 13 dB) and at follow-up the median HL was 8 dB (SD = 5 dB). However, the otologic and tympanometric findings were less encouraging. Abnormal tympanic membranes (TM) were observed in almost half the children, the rate of abnormality relating to the number of surgical interventions made. However, the TM changes may be due either to the treatment or the disease itself. The second study concerns 104 children monitored by impedance testing over a ten-year period and tends to support the hypothesis that the effusion itself is the probable cause of the changes in the TM. The third study relates to applicants for hearing aids. Excluding those with clearly defined conditions such as otosclerosis, noise trauma and Meniére's disorder, etc, two clear groups emerged, one with uncontaminated sensorineural (SN) loss, the other with mainly SN loss but with a significant conductive overlay. Though the median hearing losses of the two groups are the same, the average age for the SN group (77;SD = 7 years) is 12 years greater than that of the "conductive" group (65;SD = 14 years). Few of the SN group can recall auditory dysfunction in childhood, but the majority of the conductive group have clear recall. It seems probable that middle ear disorders in childhood may give rise to auditory impairment in the elderly such that when combined with age-associated hearing loss the need for prosthetic aid arises at a much lower age.