Ear-related Problems Research Articles

An ethnobotanical investigation of medicinal plants used among rural communities in Northeastern Madhya Pradesh, India: a quantitative study

The present study aims to document and analyze information related to significant ethnomedicinal plants in rural communities of Northeastern Madhya Pradesh, India. Data collection involved the use of open-ended and semi-structured questionnaires to gather information on ethnomedicinal plant usage, including specific plants, applications, and traditional healing practices. Quantitative indices such as Relative frequency of citation (RFC), Use value (UV), Family use value (FUV), Informant consensus factor (ICF), and Jaccard’s coefficient of similarity (JCS) were employed to quantify and analyze the gathered information. A total of 201 medicinal plants, belonging to 170 genera and 76 families, were recorded for treating various diseases, with trees (43%), herbs (33%), and climbers (13%) being predominantly used. Plants such as Hedychium coronarium and Cordia macleodii exhibited high RFC and high UV, particularly for treating eye and blood pressure problems. Vanda tessellata showed a high informant consensus factor for treating ear-related problems. Positive correlations were found between RFC and UV (0.631) and RFC and FUV (0.159). The study highlights the prevalence of traditional healing practices using medicinal plants in the area. Documentation of ethnomedicinal species and their therapeutic applications could stimulate further exploration into phytochemical and pharmacological investigations, potentially leading to the development of novel pharmaceuticals.

Prevalence of Ear-Related Problems in Individuals Recovered From COVID-19.

The aim was to assess prevalence of tinnitus, hyperacusis, hearing and balance problems among patients recovered from COVID-19 infection. Self-reported ear and hearing symptoms were compared in three groups comprising: confirmed COVID-19, possible COVID-19, and non-COVID-19. 1649 participants completed the survey in this cross-sectional study. The mean age was 34 years and 65% were female. Participants with confirmed and possible COVID-19 were asked if after their infection (compared to the past) they experienced hearing loss, ringing or whistling noises, fullness or blockage in their ears, loudness of the sounds that are normal to other people bother them more (an indication of hyperacusis), dizziness, giddiness, or imbalance. Among participants with confirmed COVID-19, 16% reported that compared to the past their hearing has decreased, 21.5% noticed tinnitus, 22.5% aural fullness, 26.1% hyperacusis and 17.3% balance problems. Regression models showed that compared to the non-COVID-19 group, participants with confirmed COVID-19 had odds ratios (ORs) of significantly greater than 1 in predicting presence of self-reported symptoms of hearing loss, tinnitus, aural fullness, hyperacusis and balance problems, OR=1.96 (p=0.001), OR=1.63 (p=0.003), OR=1.8 (p<0.001), OR=2.2 (p<0.001), and OR=2.99 (p<0.001), respectively. There seem to be higher prevalence of self-report symptoms of ear-related problems among individuals with confirmed COVID-19 infection compared to a non-COVID-19 group during the pandemic.

Pattern and awareness of complementary and alternative medicine usage for otorhinolaryngological problems among residents in Ekiti State.

The use of complementary and alternative medicine (CAM) in the treatment of various ailments globally has called for more research. This study aimed to draw the attention of the stakeholders to the prevalence, pattern and awareness of CAM usage in otorhinolaryngological ailments and the need to safeguard the health of CAM users in Ekiti state, south - west Nigeria. This is a cross sectional descriptive study carried out over a 12-month period (January to December, 2019) among consented patients that attended ear, nose, and Throat (ENT) clinics in two tertiary health institutions in Ekiti state. All the participants are aged 18 years and above. A self-administered semi structured questionnaire was used to collect data from our respondents. A total of 148 respondents were analyzed comprising of 56 (37.8%) males and 92 (62.2%) females given a male to female ratio of 1:1.6. Their age ranged from 20-79 years with a mean of 48.03 ± 15.11 SD. The highest response was in the age group 40-49 years representing 30.4% of the respondents. About half (51.4%) of our respondents were aware of the use of CAM for throat-related conditions. Few of the respondents (18.9%) are currently using CAM. About 33.1% of our respondents were satisfied with CAM. Only 4 (2.7%) of them experienced side effects to the use of CAM. For ear-related problems, Anointing/Olive (Olea europaea) oil was most commonly used in 34.5% of our respondents; Effinrin (Ocimum gratissimum), a local herb was commonly used in 29.7% for nose and local gin in 37.2% of our respondents for throat problems. Majority of them 44 (29.7%) got information about the various agents used through Vendors/traditional health practitioner. This study showed that the prevalent of CAM usage in ORL is quite low in our setting, which represent about one-fifth of the respondents. Although respondents claimed that the system was efficacious, awareness to its usage was very low and there was no evidence to prove that the diagnosis were known before using CAM. The use of Orthodox method in treating Otorhinolaryngological ailments is still the best. We therefore recommend empirical studies on CAM in future.

Psychopathological symptoms as a common Risk Factor for Tinnitus distress and magnitude: A cross-sectional study.

To examine the association of tinnitus distress, tinnitus magnitude and psychopathological symptoms among patients with ear-related problems. The cross-sectional study was conducted from December 1, 2020, to June 30, 2021, at the Hearing and Balance Clinic, Rawalpindi, Pakistan, in collaboration with the National Institute of Psychology, Quaid-i-Azam University, Islamabad, Pakistan, and comprised adult tinnitus patients of either gender. All patients underwent ear examination and audiological evaluations for tinnitus matching. Psychological assessment was done using the Tinnitus Magnitude Index, the Tinnitus Reaction Questionnaire and the Symptoms Check List-90. Data was analysed using SPSS 21. Of the 159 subjects, 97(61%) were male and 62(39%) were females. The overall mean age was 47.94±17.47 years. Patients showed statistically significant tendency to develop psychopathological symptoms, including somatisation, phobic anxiety, depression and paranoid ideation (p<0.05). Additionally, significant gender differences were also observed (p<0.05). There was a high prevalence of tinnitus distress along with psychopathological symptoms among tinnitus patients.

The role of tinnitus distress in the development of somatization symptoms among patients: implications for health care in Pakistan

Purpose Tinnitus patients are among the most vulnerable group to develop psychopathological symptoms over time if left unresolved. This study aims to investigate the role of tinnitus distress between tinnitus magnitude, cognitions and functional difficulties in the development of somatization symptoms among male and female patients experiencing ear-related problems due to lack of proper access to health care. Design/methodology/approach This study was based on a purposive sampling technique and sample consisted on 159 patients (97 male, 62 female) having tinnitus complaints, with age range 18–87 (M = 47.94, SD = 17.47) years, recruited from various clinics and hospitals of Islamabad, Pakistan, from December 2020 to July 2021. Findings The findings of this study showed that tinnitus distress is significant positively associated with tinnitus-related magnitude, negative cognitions, functional difficulties and somatization symptoms. Gender-related differences between male and female tinnitus patients revealed that females are more prone to depict higher levels of tinnitus distress, tinnitus magnitude, negative cognitions and somatization symptoms than male patients. Mediation analysis demonstrated that tinnitus distress serves as a mediator between tinnitus magnitude, cognitions, functional difficulties and somatization symptoms. Research limitations/implications Cross-sectional nature and self-reporting measures serve as a limitation of the study. An experimental study appears to be vital to ascertain the time-based relationship with tinnitus magnitude in the development of various psychopathological issues. The findings of this study contribute to the literature by highlighting the role of tinnitus distress in the origination of psychopathological symptoms like somatization and need of upgraded health-care systems in Pakistan. Originality/value This study has explored the mediating role of tinnitus distress between magnitude, cognitions, functional difficulties and somatization symptoms among Pakistani population, specifically mentioning the development of somatization symptoms among this population, which can contribute in the loss of earning and increased health expenses due to unawareness of proper health-care approach.

Ear-Related Problems among Headphone users in the Kingdom of Saudi Arabia

Background and Objectives: The middle ear cleft and the tympanum inflammation are defined as otitis media. The patient's use of headphones has been linked to aural hygiene issues and ear canal infections. Interestingly, there are not enough studies discussing the hazardous effects of prolonged use of headphones. This study aims to estimate the prevalence of ear infection among headphone users. Materials and Methodology: A cross-sectional study was conducted between February 2021 and December 2021 among 435 Saudi participants through a pretested questionnaire that was published using an online-based (electronic) form. The questionnaire included items related to pattern of hearing devices used among them and ear-related problems. This study includes all persons using earphones in the Kingdom of Saudi Arabia whose native language is Arabic. Results: Experiencing ear-related problems is statistically significantly correlated with ear infection (P = 0.000), using both ears (P = 0.000), female gender (P = 0.009), being a student (P = 0.003), using the hearing device &gt;120 min/day (P = 0.015); however, it is not statistically correlated with age, type of residency, or the type of device being used (P &gt; 0.05). Conclusion: Increased usage of hearing devices and prolonged time of use can have detrimental effects on ear problems. These possible effects are statistically significantly correlated with young age, female gender, being a student, using the device for more than 120 min/day, using the device for more than 4 years, or having chronic diseases in the past.

Functional Impacts of Aminoglycoside Treatment on Speech Perception and Extended High-Frequency Hearing Loss in a Pediatric Cystic Fibrosis Cohort.

Purpose The purpose of this study is to better understand the prevalence of ototoxicity-related hearing loss and its functional impact on communication in a pediatric and young adult cohort with cystic fibrosis (CF) and individuals without CF (controls). Method We did an observational, cross-sectional investigation of hearing function in children, teens, and young adults with CF (n = 57, M = 15.0 years) who received intravenous aminoglycoside antibiotics and age- and gender-matched controls (n = 61, M = 14.6 years). Participants completed standard and extended high-frequency audiometry, middle ear measures, speech perception tests, and a hearing and balance questionnaire. Results Individuals with CF were 3-4 times more likely to report issues with hearing, balance, and tinnitus and performed significantly poorer on speech perception tasks compared to controls. A higher prevalence of hearing loss was observed in individuals with CF (57%) compared to controls (37%). CF and control groups had similar proportions of slight and mild hearing losses; however, individuals with CF were 7.6 times more likely to have moderate and greater degrees of hearing loss. Older participants displayed higher average extended high-frequency thresholds, with no effect of age on average standard frequency thresholds. Although middle ear dysfunction has not previously been reported to be more prevalent in CF, this study showed that 16% had conductive or mixed hearing loss and higher rates of previous otitis media and pressure equalization tube surgeries compared to controls. Conclusions Individuals with CF have a higher prevalence of conductive, mixed, and sensorineural hearing loss; poorer speech-in-noise performance; and higher rates of multiple symptoms associated with otologic disorders (tinnitus, hearing difficulty, dizziness, imbalance, and otitis media) compared to controls. Accordingly, children with CF should be asked about these symptoms and receive baseline hearing assessment(s) prior to treatment with potentially ototoxic medications and at regular intervals thereafter in order to provide otologic and audiologic treatment for hearing- and ear-related problems to improve communication functioning.

Indigenous context of vertigo: translation and validation of dizziness handicap inventory for diagnosis and evaluation of patients in Pakistani hospitals

PurposeThe purpose of this paper is to focus on the indigenous need for public health challenges being faced by the patients in Pakistan because of vertigo symptoms. Vertigo or benign paroxysmal positional vertigo is described as short episodes of dizziness (spinning sensations) that are caused because of movements of head in varying directions. Various published accounts have linked vertigo to psychological and psychiatric symptoms, which include stress, anxiety and depression. The aim of present study is to examine the validity and reliability of Dizziness Handicap Inventory (DHI) Urdu version that is vital in the diagnosis, evaluation and treatment of patients coming in hospitals.Design/methodology/approachThis present study included two segments, namely, preliminary and main study. Preliminary study results indicated that the overall scale had high internal consistency of DHI Urdu version α = 0.95. The overall scale retained a high test-retest correlation tested over a period of 15 days (r = 0.93). Main study was performed on 222 vestibulocochlear disorder patients having chief complaints of tinnitus and vertigo, age ranged from 18 to 89 (M = 46.14; SD = 16.64) and recruited from various hospitals of Islamabad and Rawalpindi, Pakistan. Purposive sampling technique was applied based on cross-sectional design.FindingsSignificant correlations were noted between dizziness symptoms rating on the translated scale. Confirmatory factor analysis was used to determine the structure of the scales; an orthogonal rotation (Varimax) was conducted on the data collected from patients. A three-factor solution was obtained for DHI, the factors obtained were associated to the subscales vestibular handicap, vestibular disability and visuo-vestibular disability, demonstrating a strong factorial validity in the Pakistani cultural context.Originality/valueVertigo is a symptom that initiates various psychological issues among vestibulocochlear disorder patients (patients having ear related problems) around the world and therefore the investigated inventory offers an initial assessment for the severity of dizziness. Current research will help in the development of indigenous measures to ascertain the severity of the symptoms triggering various other mental health-related issues.

Persistent Hearing Loss among World Trade Center Health Registry Residents, Passersby and Area Workers, 2006-2007.

Background: Prior studies have found that rescue and recovery workers exposed to the 9/11 World Trade Center (WTC) disaster have evidence of increased persistent hearing and other ear-related problems. The potential association between WTC disaster exposures and post-9/11 persistent self-reported hearing problems or loss among non-rescue and recovery survivors has not been well studied. Methods: We used responses to the World Trade Center Health Registry (Registry) enrollment survey (2003–2004) and first follow-up survey (2006–2007) to model the association between exposure to the dust cloud and persistent hearing loss (n = 22,741). Results: The prevalence of post-9/11 persistent hearing loss among survivors was 2.2%. The adjusted odds ratio (aOR) of hearing loss for those who were in the dust cloud and unable to hear was 3.0 (95% CI: 2.2, 4.0). Survivors with persistent sinus problems, headaches, PTSD and chronic disease histories had an increased prevalence of reported hearing problems compared to those without symptoms or chronic problems. Conclusions: In a longitudinal study, we observed an association between WTC-related exposures and post-9/11 self-reported hearing loss among disaster survivors.

Prevalence of communication disorders in Port Blair-Andaman and Nicobar Islands

ObjectiveAndaman and Nicobar Islands is a union territory in the Indian sub-continent with a very diverse and large population. There was no existing data regarding the prevalence of communication disorder in this region and hence, this study was taken up. This information was considered essential for creating awareness among the population about communication impairments, for providing rehabilitation and to improve policies and facilities for the affected individuals. MethodThe study was completed in two phases. In the first phase, a door to door survey was carried out by students and staffs of All India Institute of Speech and Hearing, Mysuru, in the islands. During this phase, all individuals with communication disorders were identified and referred for a two-day camp that followed. The second phase involved diagnosis and rehabilitation of these referred individuals in a camp site set in a well accessible point in the capital city of Port Blair. Results4.12% of the population that was surveyed got referred for the camp. Amongst the referred individuals who participated in the camp, the prevalence of ear-related problems was estimated to be 47.76%, and that of speech and language disorders came up to 52.24%. It was also noticed that males were more affected by communication disorder than females. ConclusionThe prevalence values were found to be quite high in city of Port Blair and immediate action is required in terms of facilities and infrastructure in these areas for improving the quality of life of individuals with communication disorders.

The evaluation of the quality of life in a healthy population with the use of the COMQ-12 questionnaire

The COMQ-12 questionnaire has been elaborated to evaluate the deterioration in the quality of life of the subjects suffering from chronic suppurative otitis media (CSOM) based on the reports of the patients themselves. This questionnaire is of special interest in that it allows to register the complaints of the patients stated by them in the order of priority beginning from those that are responsible for the most pronounced manifestations of the impairment in the quality of life. It, in turn, helps the medical practitioner to rationally organize the treatment of a concrete patient taking into consideration his or her individual expectations. At the current stage of the development and adaptation of the COMQ-12 questionnaire, the main emphasis is placed on the search for the possible range of the key scores and their normal values allowing to characterize the quality of life in the healthy population. The objective of the present work was to estimate the potential of the COMQ-12 questionnaire for the evaluation of the quality of life among the subjects having no signs of chronic suppurative otitis media. A total of 60 healthy volunteers were recruited for the study and asked to fill up the questionnaire. The following information was selected for the subsequent analysis: sex and age of the respondents, experience with having any ear-related problems other than those related to chronic suppurative otitis media in the course of the lifetime. The patients presenting with chronic suppurative otitis media were excluded from the study. The score values ranged from 0 to 14 among the entire set of the respondents (mean 3.55). The resulting score of the respondents' condition was 5 and less in 75% of the cases; it achieved 10 and less out of the possible maximum of 60 scores in 95% of the participants of the study. It is concluded that the application of the COMQ-12 questionnaire helps to concentrate the attention of the medical specialists on the subjects whose health condition is characterized by score 5 or less and motivates them to carry out the thorough and comprehensive analysis for the interpretation of the data in favour of or against the prescription of the surgical intervention taking into consideration the personal expectations of the patients.

Prevalence of communication disorders in a group of islands in India

BackgroundLakshadweep is a union territory of India which is a socially and geographically secluded part from the main land giving rise to increased inbreeding; one of the causes for the communication disorders. Information about prevalence of communication disorders is essential for the prevention, policy decision making and providing effective rehabilitation services. The study was conducted as a part of fieldwork by staff and students of the AIISH to estimate the prevalence of communication disorders in Lakshadweep. MethodA door to door survey was conducted in 5 islands (surveyed population: 22,558) of Lakshadweep to identify the population at risk for communication disorders. Those who were at risk were screened to identify the same in the second phase. Screening was conducted in camps held at three islands. The prevalence of communication disorders was then estimated for the at-risk population. ResultsThe percentage of individuals who were at-risk of communication disorders as estimated from the survey data was found to be 3.63%. Among those who appeared for the screening camp 42.64% of individuals were found to have ear related problems and 57.36% individuals had speech–language disorders. Also, males had higher prevalence of ear related (53.77% against 46.23%) and speech language related problems (60.29% against 39.71%). ConclusionsThe prevalence of hearing loss was lesser and the prevalence of speech–language disorders higher compared to the mainland. Among the communication disorders, speech and language disorders were more prevalent. Males were more prone to the communication disorders than females.

Ear-related problems among children attending the paediatric and otorhinolaryngology out-patients clinics of the University of Nigeria Teaching Hospital, Enugu.

Ear related diseases are commonly seen in clinics worldwide especially among children. They are associated with significant morbidity and frequent hospital visits. Limited data exists regarding the burden of ear disease among Nigerian children. To determine the prevalence of ear-related problems among children presenting at the Paediatric and Otorhinolaryngology clinics of the University of Nigeria Teaching Hospital, Enugu. This was a cross-sectional study conducted at the Paediatric and Otorhinolaryngology Clinics of the University of Nigeria Teaching Hospital Enugu. All children aged 0 and 17 years presenting between 1(st) June and 31(st) August 2006 with ear-related problems were enrolled consecutively into the study. Data analysis was by SPSS version 11. Three thousand and twenty-one children were seen during the study period. Out of these, 248 children (8.2%) presented with ear-related problems. Chronic otitis media (30.5%), acute otitis media (29.9%), cerumen auris (11.3%), otitis externa (10.1%), hearing impairment (7.3%) and foreign body in the ear (5.7%) were the most commonly diagnosed ear-related problems. Ear-related problems among children presenting at the UNTH Enugu were not uncommon. However, otitis media was the most commonly diagnosed ailment affecting the ears in children.

The challenges of Otologic Practice in an emerging Otorhinolaryngological Unit at Federal Medical Centre, Makurdi

Otological cases abound world over, our Centre inclusive. But the challenges of setting up an Ear, Nose, Throat, Head and Neck Surgery unit in an emerging Tertiary Centre are enormous. These include lack of basic practicing tools despite the high volume of patients seen. This study was to give an audit and management of otological cases seen despite the challenges of not having basic working implement, at the Federal Medical Centre, Makurdi. This was a three year retrospective study carried out between April 2009 and March 2012. Medical records of 1786 patients who had one form of ear related pathology were examined. Data retrieved were Age, Sex, Investigations, Diagnosis, and Treatment received with its outcome. A total of 3768 patients were attended to in this period. Of these, 1786(47.4%) patients had ear related problems. Chronic Suppurative Otitis Media accounted for 620(34.7%), Hearing loss (conductive, sensorineural, and mixed) 306(17.1%), Cerumen auris 254(14.2%), Tinnitus 230(12.9%), Acute Suppurative Otitis Media 122(6.8%), Otomycosis 106(5.9%), Otitis Externa 50(2.8%), Otitis Media with Effusion 18(1.0%). Others included foreign bodies 48(2.7%), and traumatic tympanic membrane perforation 32(1.8%). Otological cases still remain a significant problem in ear, nose and throat practice, so efforts should be made to train more personnel and equip the unit for better service delivery.

Growth Hormone Treatment Does Not Affect Incidences of Middle Ear Disease or Hearing Loss in Infants and Toddlers with Turner Syndrome

Context: No randomized, controlled, prospective study has evaluated the effect of growth hormone (GH) on the rates of middle ear (ME) disease and hearing loss in girls with Turner syndrome (TS). Design: A 2-year, prospective, randomized, controlled, open-label, multicenter, clinical trial (‘Toddler Turner Study’; August 1999 to August 2003) was carried out. Setting: The study was conducted at 11 US pediatric endocrine centers. Subjects: Eighty-eight girls with TS, aged 9 months to 4 years, were enrolled. Intervention: The interventions comprised recombinant GH (50 µg/kg/day, n = 45) or no treatment (n = 43) for 2 years. Main Outcome Measures: The outcome measures included occurrence rates of ear-related problems, otitis media (OM) and associated antibiotic treatments, tympanometric assessment of ME function and hearing assessment by audiology. Results: At baseline, 57% of the girls (mean age = 1.98 ± 1.00 years) had a history of recurrent OM, 33% had undergone tympanostomy tube (t-tube) insertion and 27% had abnormal hearing. There was no significant difference between the treatment groups for annual incidence of OM episodes (untreated control: 1.9 ± 1.4; GH-treated: 1.5 ± 1.6, p = 0.17). A quarter of the subjects underwent ear surgeries (mainly t-tube insertions) during the study. Recurrent or persistent abnormality of ME function on tympanometry was present in 28–45% of the girls without t-tubes at the 6 postbaseline visits. Hearing deficits were found in 19–32% of the girls at the annual postbaseline visits. Most of these were conductive deficits, however, 2 girls had findings consistent with sensorineural hearing loss, which was evident before 3 years of age. Conclusions: Ear and hearing problems are common in infants and toddlers with TS and are not significantly influenced by GH treatment. Girls with TS need early, regular and thorough ME monitoring by their primary care provider and/or otolaryngologist, and at least annual hearing evaluations by a pediatric audiologist.

A double-blind randomised placebo-controlled trial of topical intranasal corticosteroids in 4- to 11-year-old children with persistent bilateral otitis media with effusion in primary care

To determine the clinical effectiveness and cost-effectiveness of topical mometasone in children with bilateral otitis media with effusion (OME). A double-blind randomised placebo-controlled trial with an intention to treat analysis; the 10.6% of patients lost to follow-up at 1 month were censored in the analysis. 76 Medical Research Council General Practice Research Framework practices throughout the UK between 2004 and 2007. A sample of 217 children aged 4-11 years was selected from those presenting to their GP with one or more episodes of otitis media or ear-related problems in the previous 12 months whom the research nurse confirmed had bilateral glue ear using microtympanometry (B B or B C2 types using a modified Jerger classification) at randomisation. Mometasone 50 micrograms in each nostril or placebo spray once daily for 3 months. The primary outcome was the proportions of children cleared of OME assessed by tympanometry at 1 month. Secondary outcomes included clearance at 3 months and 9 months; adverse events; OM8-30 scores (a functional health status responsive disease-specific measure); hearing loss; days with otalgia; cost-effectiveness; and health utilities. Of the topical steroid group, 40.6% (39/96) demonstrated tympanometric clearance (C1 or A type) in one or both ears at 1 month, compared with 44.9% (44/98) of the placebo group. The absolute risk reduction at 1 month was -4.3% (95% CI -18.05% to 9.26%); the odds ratio (OR) was 0.84 (95% CI 0.48 to 1.48). Four covariates were pre-specified for inclusion in logistic regression analysis: age as a continuous variable (p = 0.94), season (p = 0.70), atopy (p = 0.61) and clinical severity (p = 0.006). The adjusted OR (AOR) at 1 month for the main outcome was 0.93 (95% CI 0.50 to 1.75). Secondary analysis at 3 months showed 58.1% of the steroid group had resolved and 52.3% of the placebo group, AOR 1.45 (95% CI 0.74 to 2.84). At 9 months 55.6% of the treated group remained clear in at least one ear and 65.3% of the placebo group, AOR 0.82 (95% CI 0.39 to 1.75). Adverse events (although relatively minor) occurred in 7-22% of children and included nasal stinging, epistaxis, dry throat and cough. The OM8-30 scores (p = 0.55) reported hearing difficulty (p = 0.08), and days with otalgia (p = 0.46) were not significantly different between groups at 3 months. The economic evaluation found the active treatment arm to be dominated by placebo, accruing slightly (but not significantly) higher costs and fewer quality-adjusted life-years (QALYs), with a 24.2% probability that topical steroids are a cost-effective use of NHS resources at a ceiling ratio of 20,000 pounds per QALY gained. Use of topical intranasal corticosteroids is very unlikely to be a clinically effective treatment for OME (glue ear) in the primary care setting. Current Controlled Trials ISRCTN38988331.

Occupational noise exposure and hearing loss characteristics of a blue-collar population.

Recent studies of health effects from chronic exposure to noise in the workplace have not consistently addressed nonoccupational variables. A cross-sectional study was conducted with 197 randomly selected male hourly workers from a noisy plant (greater than or equal to 89 dBA) in Pittsburgh to fully assess noise exposure and hearing loss, incorporating information on duration of exposure, noise level, occupational and medical histories, audiometric evaluation, and external noise sources. Population audiometric profiles are characteristic of noise-induced hearing loss; mean hearing thresholds for press room men were significantly higher at 2, 3, and 6 kHz (p less than or equal to .05). Only 40% of the men consistently wore hearing protection. Recent use of ototoxic drugs, noisy hobbies/second jobs, military service, family history of hearing loss, and ear-related problems were not found to have a significant effect on hearing levels at high frequencies, suggesting that observed hearing losses were of an occupational origin.