Conductive Hearing Loss In Children Research Articles

Outcome of Primary Stapedotomy in 21 Consecutive Cases of Juvenile Otosclerosis.

Otosclerosis is a relatively uncommon condition that causes conductive hearing loss in children. The preferred treatment for adults is stapedotomy, while for individuals under 18 years old, there is an ongoing discussion about the best treatment approach. Thus, the surgical procedure for the stapes in pediatric patients continues to be a subject of debate. This study aimed to evaluate the results of stapes surgery in children, trying to understand, based on our results, whether this is actually the most suitable option. The study included 18 patients who underwent surgery between January 2013 and December 2023. The patients' ages ranged from 11 to 18 years, with an average age of 14.7. Out of the total 21 surgeries, three patients opted for bilateral surgery. Pre- and post-operative data were compared, focusing on the mean air conduction (AC) and bone conduction (BC) thresholds at frequencies of 0.5, 1, 2, and 4 kHz. Additionally, pre-operative thresholds and the post-operative air-bone gap (ABG) were examined. After a year, the air-bone gap was effectively reduced to 10 dB or less in 94% of the 21 cases, and to 20 dB or less in 98% of all cases. Our results and research in the field have consistently shown that stapedotomy, when conducted by skilled otosurgeons, is a reliable and successful procedure for a considerable number of patients. The outcomes it generates are similar to those achieved through the procedure conducted during adulthood.

Congenital cholesteatoma: what radiologists need to know.

Congenital cholesteatoma is a rare, non-neoplastic lesion that causes conductive hearing loss in children. It is underrecognized and often diagnosed only when there is an established hearing deficit. In the pediatric population, hearing deficiency is particularly detrimental because it can impede speech and language development and, in turn, the social and academic well-being of affected children. Delayed diagnosis leads to advanced disease that requires more extensive surgery and a greater chance of recurrence. A need to promote awareness and recognition of this condition has been advocated by clinicians and surgeons, but no comprehensive imaging review dedicated to this entity has been performed. This review aims to discuss the diagnostic utility of high-resolution computed tomography and magnetic resonance imaging in preoperative and postoperative settings in congenital cholesteatoma. Detailed emphasis is placed on the essential preoperative computed tomography findings that facilitate individualized surgical management and prognosis in the pediatric population.

Severity and Types of Hearing Loss in Patients with Hypertrophic Adenoids

Background: Hearing loss in children can significantly impact language development and social interaction. Hypertrophic adenoids are a common pediatric condition that can contribute to hearing impairments. Understanding the prevalence and severity of hearing loss in this demographic is crucial for effective management and intervention strategies. Objective: The study aimed to determine the prevalence and severity of hearing loss among children with hypertrophic adenoids, assessing the demographic characteristics and the types of hearing loss observed in this population. Methods: This observational cross-sectional survey was conducted over nine months at the Children's Hospital and Institute of Child Health, University of Lahore Teaching Hospital. The study included a sample size of 339 children aged 5-13 years, calculated based on a prevalence rate of 67.3% for mild hearing loss. Children with comorbidities like Down syndrome, Autism, ADHD, and other disabilities were excluded. Hearing assessments were conducted using an otoscope, a tympanometer, and a diagnostic audiometer (MAICO MA41 model). Data were analyzed using SPSS Version 25.0, focusing on the frequency and percentage of various types of hearing loss. Results: The study included 183 males (54%) and 156 females (46%), with a higher representation from rural areas (60%, n=203). Tympanometric analysis revealed 51.9% (n=176) with Type A tympanograms, 43.1% (n=146) with Type B, and 5% (n=17) with Type C. Audiometric results showed that 53.1% (n=180) of participants had normal hearing levels, while 27.1% (n=92) experienced mild hearing loss, 16.2% (n=55) had moderate hearing loss, 3.5% (n=12) had moderately severe hearing loss, 1.5% (n=5) had sensorineural hearing loss, and 2.1% (n=7) had mixed hearing loss. Conclusion: The study demonstrates a significant occurrence of mild to moderate conductive hearing loss in children with hypertrophic adenoids, particularly in rural settings. These findings highlight the need for regular auditory screening and early intervention strategies in this demographic to prevent long-term speech and language complications.

Wideband Absorbance Predicts the Severity of Conductive Hearing Loss in Children With Otitis Media With Effusion.

The objectives of the present study were to investigate the relationship between wideband absorbance (WBA) and air-bone gap (ABG) in children with a conductive hearing loss (CHL) due to otitis media with effusion (OME) and determine the accuracy of WBA to predict the magnitude of ABGs. This was a prospective, cross-sectional study involving a control group of 170 healthy ears from 130 children (mean age 7.7 years) and a CHL cohort of 181 ears from 176 children (mean age 5.9 years) with OME. The CHL cohort was divided into three groups: CHL1, CHL2, and CHL3 defined by mean ABG (averaged across 0.5 to 4 kHz) of 16 to 25 dB, 26 to 35 dB, and 36 to 45 dB, respectively. WBA was measured at frequencies from 0.25 to 8 kHz at ambient pressure. WBA was significantly reduced between 0.25 and 5 kHz for all CHL groups. The difference in WBA at 1 to 4 kHz between the control and CHL groups increased with increasing ABG. The predictive accuracy, as indicated by area under the receiver operating characteristic curve (AUROC) of WBA, increased with increasing ABG. The AUROC for WBA at 1.5 kHz was 0.86 for the CHL1, 0.91 for the CHL2, and 0.93 for the CHL3 group. The AUROCs for WBA averaged across 0.5 to 4 kHz were 0.88, 0.93, and 0.94 for the CHL1, CHL2, and CHL3 groups, respectively. Linear regression analyses showed significant negative correlations between WBA 0.5-4 k and ABG 0.5-4 k . The regression model (ABG 0.5-4 k = 31.83 - 24.08 × WBA 0.5-4 k ) showed that WBA 0.5-4 k predicted ABG 0.5-4 k with high accuracy. Comparison of predicted and actual WBA on a different group of subjects revealed that at an individual level, the model predicted ABG between 16 and 35 with greater precision. There were significant strong correlations between WBA and ABG such that WBA decreased with increasing ABG. WBA demonstrated good discrimination accuracy with AUROC exceeding 0.88 for the 0.5 to 4 kHz and 1 to 4 kHz frequency bands. The WBA test holds promise for determining the severity of CHL in children with OME.

Conductive Hearing Loss in Children.

A variety of congenital and acquired disorders result in pediatric conductive hearing loss. Malformations of the external auditory canal are invariably associated with malformations of the middle ear space and ossicles. Isolated ossicular malformations are uncommon. Syndromes associated with external and middle ear malformations are frequently associated with abnormal development of first and second pharyngeal arch derivatives. Chronic inflammatory disorders include cholesteatoma, cholesterol granuloma, and tympanosclerosis.

Conductive hearing loss in newborns: Hearing profile, risk factors, and occasions of service.

Infants diagnosed with a conductive hearing loss (CHL) are at increased risk of developmental delays. Using a sample of infants diagnosed with CHL through UNHS, this study aimed to investigate the relationship between specific demographic or clinical characteristics and 1) occasions of service to reach a hearing diagnosis and 2) the profile of CHL. Retrospective analysis was conducted for all infants with CHL born between 01/01/2007 and 31/12/2018 who had received UNHS. Chi squared analysis was conducted on data from 1208 records. Infants with ≥1 risk factor for hearing loss were more likely to attend more than three occasions of service. Infants who were bilateral refer/medical exclusion, Torres Strait Islander, had ≥1 risk factors for hearing loss or were born pre-term had greater proportions of bilateral CHL than unilateral CHL. Mild to moderate was the most frequent degree of CHL, although a unilateral or bilateral CHL did not have an association with the severity of CHL. Compared to other risk factors, infants with a syndrome had greater proportions of bilateral than unilateral CHL. Risk factors of craniofacial abnormality, prolonged ventilation, or syndrome had greater proportions of mild to moderate CHL than moderate or greater. On average, infants were diagnosed with a CHL at 37.29 weeks of age. These findings highlight the relationship between clinical/demographic characteristics and occasions of service to diagnose CHL in children, including the CHL profile. An understanding of this relationship may help clinicians to better plan, assess and manage infants diagnosed with a CHL through UNHS.

Etiology analysis and diagnosis of noninflammatory conductive hearing loss in children

Objective:To investigate the etiology, diagnosis and treatment of noninflammatory conductive hearing loss in children. Methods:The clinical data of children patients admitted to the Eye & ENT Hospital of Fudan University from January 2019 to November 2022 were retrospectively analyzed. Results:A total of 179 cases（189 ears） were analyzed. The main symptoms from high to low were: ear tightness, hearing loss, earache, and facial paralysis. The degree of hearing loss was mild in 34 ears（19.5%）, moderate in 70 ears（40.2%）, moderate-severe in 52 ears（29.9%）, severe in 18 ears（10.3%）. The mean hearing threshold of otosclerosis was the highest（63.5±7.8） dB HL, and the mean air-bone gap of ossicular chain malformation was the largest（35.4±9.8） dB HL. The mean hearing threshold of the affected ear was（50.4±14.5） dB HL, and the mean air bone gap was（30.3±10.4） dB HL. After operation, the results were（36.1± 14.5） dB HL and（20.0±8.6） dB HL, respectively. Distribution of surgical methods for ossicular chain reconstruction: 88 ears（46.6%） of TORP, 49 ears（25.9%） of PORP, 8（4.2%） ears of Piston, 9 ears（4.8%） of autogenous ossicular reconstruction, and 35 ears（18.5%） of ossicular chain relaxation. CT diagnostic rate showed more sensitivity to malleus and incus abnormalities, the diagnosis rate of congenital middle ear cholesteatoma was the highest. The mean duration time of diagnosis was（2.2±2.9） years, while the diagnosis of ossicular chain malformation（[5.2±4.2]years）, otosclerosis（[4.4±4.1]years）, tympanosclerosis（[5.4±0.9]years） took longer. Conclusion:In the diagnosis and treatment of noninflammatory conductive hearing loss in children, the combination of detailed medical history, specialized examination and imaging examination can maximize the accuracy of diagnosis and achieve the purpose of personalized comprehensive treatment. Surgical intervention with appropriate timing is important to remove lesions and improve hearing.

Republication de : Pediatric maxillary expansion has a positive impact on hearing? A systematic review and meta-analysis

Hearing loss is a highly prevalent condition in the pediatric population. Pediatric maxillary expansion is a widespread treatment to address transverse maxillary deficiency. First reports describing an association between improvements for patients with HL and PME initiated in the 1960s. In this systematic review and meta-analysis we aim to review the role of maxillary expansion in reducing conductive hearing loss in pediatric population. Pubmed (Medline), the Cochrane Library, EMBASE and Trip Database were checked. Main outcome was expressed as the difference between air-bone gap, compliance, ear volume and conductive hearing thresholds before and after treatment and the 95% confidence interval. A total of 10 studies (218 patients) met inclusion criteria. The pooled data in the meta-analysis under a random effects model shows a statistically significant difference of 10.57 dB mean reduction after palatal expansion. The air-bone gap was significantly reduced by 5.39 dB (CI 95% 3.68, 7.10). Compliance and volume were assessed in three studies, with a non-significant positive difference in the compliance (0.14) and a statistically significant difference for volume (0.80) after palatal expansion. This systematic review and meta-analysis found a positive effect of pediatric maxillary expansion in conductive hearing loss in well-select children. However, results cannot be extrapolated for children with conductive hearing loss without an accompanying orthodontic indication (maxillary constriction). It showed that the existing prospective studies exhibited qualitative pitfalls, limiting the ability to obtain conclusive evidence about the role of pediatric maxillary expansion on conductive hearing loss in children.

Managing Chronic otitis media with Effusion in Children with non-Syndromic Cleft Palate: Short-Term Ventilation Tubes Versus Surveillance.

To compare the effectiveness of short-term ventilation tubes compared to surveillance on conductive hearing loss in children with non-syndromic orofacial clefting involving the muscular palate. Chronic otitis media with effusion is a common finding in children with cleft palate. The accepted convention is insertion of short-term ventilation tubes at the time of palate repair, but some centres are choosing conservative management. Each approach has its advantages but there is currently no consensus on the most appropriate management in children with non-syndromic cleft palate. Children <18 years with cleft lip and palate, or isolated cleft palate, not associated with a genetic syndrome, who have been diagnosed with chronic otitis media with effusion. A systematic search of MEDLINE, CINAHL, Embase and Scopus databases was conducted. Grey literature searches were conducted through Central Register of Controlled Trials, Clinicaltrials.gov and ProQuest. Two reviewers screened the studies, conducted critical appraisal, assessed the methodological quality, and extracted the data. Where possible, studies were pooled in statistical meta-analysis with heterogeneity being assessed using the standard Chi-squared and I2 tests. Four studies met the inclusion criteria but were of low quality with a moderate risk of bias. Only data on hearing thresholds could be pooled for analysis which found no statistically significant difference. Other outcomes were presented in narrative form. Certainty of evidence for all outcomes was deemed low to very low using GRADE criteria. No definitive conclusions can be drawn regarding most effective management at improving conductive hearing loss. Missing data and inconsistent reporting of outcomes limited capacity for pooled analysis.

Pediatric maxillary expansion has a positive impact on hearing? A systematic review and meta-analysis

ObjectiveHearing loss is a highly prevalent condition in the pediatric population. Pediatric maxillary expansion is a widespread treatment to address transverse maxillary deficiency. First reports describing an association between improvements for patients with HL and PME initiated in the 1960s. In this systematic review and meta-analysis we aim to review the role of maxillary expansion in reducing conductive hearing loss in pediatric population. Review methodsPubmed (Medline), the Cochrane Library, EMBASE and Trip Database were checked. Main outcome was expressed as the difference between air-bone gap, compliance, ear volume and conductive hearing thresholds before and after treatment and the 95% confidence interval. ResultsA total of 10 studies (218 patients) met inclusion criteria. The pooled data in the meta-analysis under a random effects model shows a statistically significant difference of 10.57dB mean reduction after palatal expansion. The air-bone gap was significantly reduced by 5.39dB (CI 95% 3.68, 7.10). Compliance and volume were assessed in three studies, with a non-significant positive difference in the compliance (0.14) and a statistically significant difference for volume (0.80) after palatal expansion. ConclusionThis systematic review and meta-analysis found a positive effect of pediatric maxillary expansion in conductive hearing loss in well-select children. However, results cannot be extrapolated for children with conductive hearing loss without an accompanying orthodontic indication (maxillary constriction). It showed that the existing prospective studies exhibited qualitative pitfalls, limiting the ability to obtain conclusive evidence about the role of pediatric maxillary expansion on conductive hearing loss in children.

Effectiveness of ventilation tube insertion for conductive hearing loss in children with chronic otitis media with effusion and non-syndromic cleft palate: a systematic review protocol.

This review will investigate the efficacy of ventilation tube insertion versus non-surgical options in the management of chronic otitis media with effusion in children with non-syndromic cleft palate by assessing the degree of conductive hearing loss. Chronic otitis media with effusion is common in children with cleft palate due to associated eustachian tube dysfunction. It can lead to impaired hearing and can hinder speech and language development. The main treatment options are drainage of effusion with ventilation tubes, surveillance, or amplification with hearing aids. Each of these approaches has its advantages but there is currently no consensus on the most appropriate management in children with cleft palate. Eligible studies will include children (<18 years) with cleft palate not associated with a genetic syndrome, diagnosed with chronic otitis media with effusion, who have undergone insertion of ventilation tubes compared with either surveillance or amplification with hearing aids. A comprehensive search of MEDLINE, CINAHL, Embase, and Scopus will be conducted to find published literature. Gray literature searches will be conducted through the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and ProQuest Dissertations and Theses Global. Two reviewers will screen studies, conduct critical appraisal of eligible studies, assess the methodological quality, and extract the data. Where possible, studies will be pooled in statistical meta-analysis, with heterogeneity of data being assessed using the standard χ 2 and I2 tests. PROSPERO CRD42021255861.

Rapid Maxillary Expansion, Sleep-Disordered Breathing and Conductive Hearing Loss in Children: A Correlation

Rapid Maxillary Expansion, Sleep-Disordered Breathing and Conductive Hearing Loss in Children: A Correlation

New prognostic markers of hearing impairment in children: gene-gene interaction and approximation models

Objective: to evaluate the gene-gene interaction, assess the risks and develop some approximation models of hearing loss / deafness occurrence in children, depending on the genes polymorphism gab junction B2 (GJB2, rs80338939), and interleukin-4 (IL-4, rs 2243250) and other risk factors. Materials and methods: Study included 102 children with hearing impairment: 68 with sensorineural (SNHL) and 34 with conductive hearing loss (CHL), among them 36 (35.29%) girls and 66 (64.71%) boys. The patients' age vary from 8 to 18 yo (on the average 13.90±3.11 yo). Diagnosis set by otorhinolaryngology (ENT) methods: ENT examination, computer audiometry, impedancemetry, tympanometry. The control group included 60 practically healthy children: 22 girls (36.67%), 38 boys (63.33%). Polymorphism of GJB2 (rs80338939) and IL-4 (rs 2243250) genes was studied by polymerase chain reaction method. Risk assessed by Relative Risk, Odds Ratio and 95% Confidential intervals.Results. The combination of 35delG / TT, as well as Non-Del / TT and 35delG/ TC genotypes in the genome is associated with a high risk of hearing loss in general children population (from 0.932 to 1.432; OR=19.5; p=0.003), as well as the appearance SNHL (from 0.765 to 1.765), stronger than the combination of unfavorable homozygotes TT / 35DelG - 1.765. The combination of homozygotes for the wild allele of both genes (especially CC / Non-Del) is associated with a low risk of deafness: hearing loss in general -1,068, for SNHL -0,908, for CHL -0,750 (p&lt;0,01), for CC / 35delG combination, or TC / Non-Del: in general -0.068 -, and for SNHL -0.235 and -0.11 respectively, (p&gt;0.05).Infectious diseases in anamnesis (meningitis, measles, mumps, or rubella) increases the likelihood of CHL by 9.41 times (OR=12.0; p=0.007). Concomitant chronic non-obstructive and obstructive upper and lower respiratory tract diseases increase the risk of both SNHL and CHL in children regardless of age: for SNHL 3.75-7.81 times (OR=6.50-10.9; p≤0.028-0.01), for CHL – 4.29-8.75 times (OR=6.19-12.9; p≤0.03-0.009). The revealed dependence of the indicators is best described by the logit-regression approximating models with high multiple correlation coefficient (R2=0.9761); low standard error of the model estimation (ε=0.1114); connection criterion F=124.2; degrees of freedom df=7.43 (p&lt;0.001).Conclusions: Genes polymorphism's GJB2 (rs80338939) and IL-4 (rs 2243250) and their interactions are new prognostic markers of hearing impairment in children. Approximating models describe the likelihood of SNHL and CHL in observed population.

Management of secretory otitis media: a prospective randomised study comparing medical management with early surgical intervention

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Secretory otitis media is the most common cause of conductive hearing loss in children. Though self-limiting recurrent disease can cause speech and language delay, cognitive impairment and behavioural problems in the long term. This is a prospective study of the epidemiological profile, predisposing factors, clinical profile of secretory otitis media. This study also compares the conservative treatment with early surgical Treatment in Patient with secretory otitis media.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; The study is a prospective randomised study of patients presenting with conductive hearing loss diagnosed by pure tone audiometry. The patients were randomized into two groups of 25 patients each. The medical management arm received antihistamines and decongestants and the surgical arm patient underwent myringotomy with grommet insertion. Patients with adenoid hypertrophy underwent adenoidectomy as an additional procedure. The patients were followed up regularly and where evaluated at the end of 12 months for symptomatic improvement and hearing improvement by Pure Tone Audiogram and impedance audiogram. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The most common age group affected was between 5-15 yrs with hard of hearing and aural fullness being the most common presenting complaint. Eustachian tube dysfunction with adenoid hypertrophy was the most common precipitating factor (68%) followed by allergy and gastro esophageal reflux disease. Compared to medical treatment which resulted in a successful treatment outcome in 40% of patients, cases which underwent surgical treatment had successful outcome in 70% of cases.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Surgical management in the form of adenoidectomy/myringotomy with grommet insertion has better long term outcome in terms of hearing impairment and disease relapse and recurrence.&lt;/p&gt;

A new adhesive bone conduction hearing system effectively treats conductive hearing loss in children

ObjectivesBone conduction hearing devices integrated in softbands (BCDSs) are frequently not well accepted by children with conductive hearing loss due to pressure on the head, sweating, or cosmetic stigma. A non-surgical hearing system (ADHEAR) uses a new bone conduction concept consisting of an audio processor connected to an adhesive adapter fixed behind the ear. This study is the first to evaluate the audiological and clinical outcome of this novel system, comparing it with conventional BCDSs in a short- and mid-term follow-up in children under 10 years of age. MethodsThe ADHEAR was compared to a BCDS in 10 children with conductive hearing loss (age: 0.7–9.7 years). Aided and unaided pure tone/behavioral observational audiometry and, if applicable, speech audiometry in quiet and noise were performed initially with both devices and after 8 weeks with the ADHEAR alone. The subjective hearing gain and usage of the new hearing system, as well as patients’ and parents’ satisfaction were assessed using questionnaires. ResultsThe functional gain with the ADHEAR averaged over 0.5, 1, 2, and 4 kHz exceeded that of the conventional BCDS (35.6 dB ± 15.1 vs. 29.9 dB ± 14.6, p = .001, n = 9 ears). Speech perception in quiet and noise (n = 8) improved in the aided situation similarly for both hearing devices. The parents of 8 of 10 children evaluated the ADHEAR system as being useful. Minor wearing problems occurred occasionally. Eight children continued using the ADHEAR after the study, one received an active middle ear implant and one continued to use a BCDS. ConclusionThe ADHEAR system is a promising solution for children with conductive hearing loss or chronically draining ears.

Diagnosis and management of conductive hearing loss in children with trisomy 21.

The objective of this study is to review the prevalence and degree of hearing loss in children with trisomy 21, their response to intervention and the presence of concomitant pathologies. The project will also highlight the experiences of the children from their parents' and guardians' perspective and the link between perceived service quality and an objective improvement in their hearing after rehabilitation. All patients with trisomy 21 who were referred to district general otolaryngology outpatient clinics between 2014 and 2016 were included. A retrospective analysis of the medical notes and audiograms along with a qualitative questionnaire to the children's parents was utilised to gather the information. The study showed that 77% (17/22) of children suffered from hearing loss, with a moderate degree being most prevalent. The majority of patients (14/17, 82%) were managed conservatively, undergoing a period of watchful waiting (9/17, 53%) or receiving hearing aids (5/17, 30%) and 3 of 17 (17%) were managed with grommet insertion. The improvement in hearing with hearing aids was comparable with grommet insertion and hearing aids scored highest in the post-intervention qualitative assessment with grommet insertion scoring the lowest. Functional hearing has been shown to be key in developing speech and language skills. In children with trisomy 21, behavioural and anatomical abnormalities make the diagnosis and intervention technically more challenging. This study demonstrates that in the absence of other otological symptoms, hearing loss can be managed effectively and with the least distress to the children with hearing aids.

A functional and anatomical comparison between two passive transcutaneous bone conduction implants in children

ObjectiveTo compare anatomical and functional outcomes of two passive transcutaneous bone conduction implant systems: Sophono™ and BAHA Attract™. Materials and methodsTwenty patients, affected by bilateral conductive hearing loss, underwent unilateral transcutaneous bone conduction implant surgery. Ten children received a Sophono™ implant (6 males, 4 females, mean age 11 years, mean unaided Pure Tone Average (PTA) 0.25-4kHz = 69.70dB HL) and 10 a BAHA Attract™ system (7 males, 3 females, mean age 19 years, mean unaided PTA0.25-4kHz = 66.40dB HL). The following outcomes were considered: incidence of local complications, hearing aid benefit, hearing aid gain and changes in quality of life (QOL), as measured by the Glasgow Children's Benefit Inventory (GCBI). ResultsOne patient in the Sophono group experienced magnet-related skin decubitus, while two patients (one per group) had skin hyperemia in the area overlying the magnet. The mean BAHA-aided threshold was 23.70dB, whereas the mean Sophono-aided threshold was 31.60dB. The mean gain was significantly different for lower frequencies, the BAHA having better functional outcomes. All patients reported an improvement in their QOL. ConclusionGiven the lower thickness of the internal magnet, the Sophono™ system might be more suitable for younger children, whereas BAHA offered better functional results. Both systems can be considered valid and safe options for the functional rehabilitation of conductive hearing loss in children, provided that precautions are observed, such as a gradual use of the device and use of the least powerful magnets in the first months after the activation.

ASSESSMENT OF MOTHERS' PRACTICE OF KNOWLEDGE ABOUT CARE OF THEIR CHILDREN SUFFERING FROM OTITIS MEDIA WITH THE VIEW TO DEVELOP HEALTH EDUCATION MODULE

Background: Otitis media (OM) is one of the most prevalent illnesses of infancy and early childhood. It is the most leading cause of conductive hearing loss in children, and speech/language delay that associated with adverse social and educational outcome. Mothers play the most significant role not only in providing care for their children suffering from otitis media but also in prevention this disease which lead to improvement of quality of life of their children. This study aimed to: assess mothers' knowledge and practices about care of their children suffering from otitis media, and to develop health education module. Research design: a descriptive design was used. Setting: the study was conducted at the outpatient clinics of Ear, Nose and Throat of Mansoura University. Subjects: a convenient sample of 127 mothers whose their children were under 5 years old and suffering from otitis media, with and without complication of otitis media. Tool of data collection: data about mothers' knowledge and their practices about care of OM were collected using a structured questionnaire sheet. The Results of this study revealed that, 63.8% of the studied children their age were from 1 year to less than 3 years and there was a positive relation between mothers' knowledge and their practice to provide care for their children suffering from otitis media. This study concluded that, more than half of studied mothers had insufficient knowledge score and unsatisfactory score in practical knowledge regarding otitis media. Recommendation: regular and continuous health education programs are essential for mothers of children suffering from otitis media about care of their children and their community resources.

Parental views on otitis media: systematic review of qualitative studies.

This study aims to describe parental experiences and perspectives of caring for a child with otitis media. We conducted a systematic review of qualitative studies on parental perspectives on caring for a child with otitis media. We searched electronic databases to July 2015. Seventeen studies involving 284 participants from six countries were included. We identified seven themes: diminishing competency (guilt over failure to identify symptoms, helpless and despairing, fear of complications, disempowered and dismissed); disrupting life schedules (disturbing sleep, interfering with work, burden on family); social isolation (stigma and judgement, sick consciousness); threatening normal development (delaying growth milestones, impairing interpersonal skills, impeding education); taking ownership (recognising symptoms, diagnostic closure, working the system, protecting against physical trauma, contingency planning); valuing support (needing respite, depending on community, clinician validation); and cherishing health (relief with treatment success, inspiring resilience). The additional medical responsibilities and anxieties of parents caring for a child with otitis media, often discounted by clinicians, can be disempowering and disruptive. Chronicity can raise doubt about treatment efficacy and parental competency, and fears regarding their child's development. Care that fosters parental confidence and addresses their concerns about the child's development may improve treatment outcomes for children with otitis media. • Otitis media is a leading cause of conductive hearing loss in children. • Parental perception of the treatment burden of otitis media can potentially affect their confidence and ability to care for their child. What is New: • We identified five themes to reflect parental perspectives: diminishing competency, disrupting life schedules, social isolation, threatening normal development, taking ownership, valuing support, and cherishing health. • Parents may perceive caring for a child with otitis media as disempowering and disruptive and with reoccurrence doubt treatment efficacy and their parental competency and develop fears regarding their child's development.

Correlation of Enlarged Adenoids with conductive hearing impairment in children under twelve

Objective: To find out the relation of conductive hearing loss in children with enlarged adenoids.Methods: Study was conducted in out patients department and Indoor wards of the Department of Otolaryngology on Head Neck Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka during the periods of October 2005 to March 2006. 60 patients with enlarged amides were included in this study. The assessment of the patients were established on the basic of history clinical, 2 and audiological examination was done. Data were collected and analyzed using statistical package for Social Science.Results: In this study 60 patients (from 3 years to 12 years age) diagnosed as having ‘enlarged adenoids’ in the Otolaryngology and Head-Neck Surgery out patient and in patient Departments of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from May 2005 to March 2006 are included in this series. Most of the patients presented with multiple symptoms, the commonest was the hearing impairment (58.33%). Other common symptoms were mouth breathing (50.00%), Nasal obstruction (50.00%), snoring (46.67%). Majority of them were male (62.85%) and 53.33% were in the 5-10 years age group. Middle class family occupy the lion share (58.33%). 60.00% patients live in a overcrowded condition. 50.00% patients were found with gross enlargement of adenoids. Hearing impairment was found in 58.33% ears of-patients of adenoids. Reduced middle ear pressure and compliance were found in 64.00% ears. Among the patients of enlarged adenoids otitis media with effusion was found in 58.33% (35) of patients. Among the patients of OME majority was male (62.85%). There was 77.14% (27) bilateral and 22.85% (8) unilateral cases. On otoscopy of OME patients, all patients had retraction of tympanic membrane, cone of lights were distorted in 50.00%, fluidlevels in 68.57% and bubbles were in 28.57% of ears. 71.43% OME patients had hearing loss in the range of 26-40 dB. Middle ear pressure and compliance were found reduced in 88.57% (62) ears of OME patients. There were 58.33% incidence of OME among enlarged adenoids cases. All the patients of OME with enlarged adenoids had a hearing loss between 26-55dB. Out of the 22 OME cases with gross adenoids, 16 had a middle ear pressure between -201 to-300 mm of H20 and 19 had a middle ear pressure between -101 to -200 mm of H20. On myringotomy fluid came out from all 62 (100%) ears. From majority (38) ears serous type of fluid came out.Conclusion: This is an endeavor to find out a correlation of enlarged adenoids with conductive hearing impairment in children. Otitis media with effusion is suspected in all children suffering from enlarged adenoids. All together 60 patients with enlarged adenoids were included in the study. Result of this study may not be the actual picture of overall situation due to many limitations is this study. Still it can be concluded that enlarged adenoids has a definite role in causing OME and conductive hearing impairment. So early diagnosis and treatment of enlarged adenoids can be encouraged to decrease the actual incidence, morbidity and complications of otitis media with effusion and thus conductive hearing impairment in childhood.Bangladesh J Otorhinolaryngol; October 2015; 21(2): 62-68