History Of Middle Ear Infections Research Articles

Suprathreshold Auditory Measures for Detecting Early-Stage Noise-Induced Hearing Loss in Young Adults.

Over 1 billion young adults are at risk for developing noise-induced hearing loss (NIHL) due to their habit of listening to music at loud levels. The gold standard for detecting NIHL is the audiometric notch around 3,000 to 6,000 Hz observed in pure tone audiogram. However, recent studies suggested that suprathreshold auditory measures might be more sensitive to detect early-stage NIHL in young adults. The present study compared suprathreshold measures in individuals with high and low noise exposure backgrounds (NEBs). We hypothesized that individuals with high NEB would exhibit reduced performance on suprathreshold measures than those with low NEB. An initial sample of 100 English-speaking healthy adults (18-35 years; females = 70) was obtained from five university classes. We identified 15 participants with the lowest NEB scores (10 females) and 15 participants with the highest NEB scores (10 females). We selected a sample of healthy young adults with no history of middle ear infection, and those in the low NEB group were selected with no history of impulse noise exposure. The study included conventional audiometry, extended high-frequency audiometry, middle ear muscle reflex (MEMR) thresholds, distortion-product otoacoustic emissions (DPOAEs), QuickSIN, and suprathreshold auditory brainstem response (ABR) measures. We used independent sample t-tests, correlation coefficients, and linear mixed model analysis to compare the audiometric measures between the NEB groups. The prevalence of audiometric notch was low in the study sample, even for individuals with high NEB. We found that: (1) individuals with high NEB revealed significantly reduced QuickSIN performance than those with low NEB; (2) music exposure via earphone revealed a significant association with QuickSIN; (3) individuals with high NEB revealed significantly reduced DPOAEs and ABR wave I amplitude compared with individuals with low NEB; (4) MEMR and ABR latency measures showed a modest association with NEB; and (5) audiometric thresholds across the frequency range did not show statistically significant association with NEB. Our results suggest that young adults with high NEB might exhibit impaired peripheral neural coding deficits leading to reduced speech-in-noise (SIN) performance despite clinically normal hearing thresholds. SIN measures might be more sensitive than audiometric notch for detecting early-stage NIHL in young adults.

Efficacy of Multicomponent Tympanometry in Identifying Middle Ear Disorder.

Multi component tympanometry is not widely used in clinics due lack of evidence supporting its usefulness. The present study was undertaken to investigate the efficacy of multicomponent tympanometry for 1000Hz probe tone in detecting middle ear pathology. Data were collected from 20 ears of 10 participants with no history of middle ear pathology (Group I) and 39 ears of 26 participants (Group II) with history of middle ear infection or ear-pain or blocking sensation. Single component tympanometry for 226Hz probe tone and Susceptancec and Conductance tympanograms for 1000Hz probe tone was carried out on all the participants. Results revealed normal tympanogram for both the probe tones for all the participants of Group I. It was observed that 53.84% of the ears could be identified as having middle ear pathology using 226Hz probe tone whereas the percentage of correct identification increased to 94.87% when 1000Hz probe tone was used. They are in accordance with the concept that subtle changes in the middle ear which cannot be detected by 226Hz tympanogram can be identified using 1000Hz multicomponent tympanogram. These findings highlight the efficiency of 1000Hz probe tone in detecting mass dominant middle ear pathology.

Middle ear disease in Danish toddlers attending nursery day-care – Applicability of OM-6, disease specific quality of life and predictors for middle ear symptoms

ObjectivesOtitis media (OM) is a very common childhood disease and impacts child quality of life (QoL) to different extends. The aim of this study was to investigate the difference in quality of life between three groups of children; Children with symptoms of ear disease within the last 4 weeks, children without any ear disease and children scheduled for ventilating tube treatment. Furthermore, we investigated predictors for experiencing middle ear symptoms. Lastly, we assessed psychometric properties of OM-6 used to assess QoL. MethodsFour hundred ninety-four children attending nursery day-care aged 6–36 months were enrolled in the study. Caregivers were asked to recall the child's history of symptoms related to middle ear infection. The Danish version of otitis media-6 questionnaire was used to measure the children's quality of life. Data from children treated with ventilating tubes were included from a previously published study. Logistic regression was applied for determining possible predictors for experiencing ear related symptoms. ResultsThe study had an 87% response rate, with a total of 342 children included. At the inclusion 32 (9%) children were included in the 4-week group and, while 307 children were allocated to the non-4 week group. The children in the 4-week group were significantly younger and were more likely to have siblings with a history of middle ear infection than the non-4week group. Furthermore, QoL was significantly worse in the 4-week group compared to the non-4week group. Only subtle differences were found between children with acute symptoms compared to children scheduled for tube treatment. ConclusionsAs expected, children with acute symptoms of OM experience lowered QoL compared to children with no symptoms and young age as well as having siblings with a history of middle ear problems were found to be possible predictors for experiencing middle ear symptoms. Children with acute symptoms differed from children scheduled for ventilating tubes on domains related to long-term problems from OM. OM-6 has shown to be a valid instrument for assessing disease specific QoL in children with OM, however a more large-scale instrument might be necessary for detecting subtle differences between subgroups of children with OM.

An Epidemiologic Study of Tinnitus in a Population in Jiangsu Province, China

Tinnitus is a common complaint and often of no clinical significance. There are a number of unresolved issues concerning the etiology, pathogenesis, and natural history of tinnitus. There are a few current population-based estimates of the prevalence of tinnitus done in representative large geographic areas, but there is little data from multi-area, large sample studies of tinnitus in China. To investigate the prevalence of tinnitus and related factors in a Chinese population. These data would be used to plan and evaluate health-care services. We carried out an epidemiologic study of tinnitus as part of an epidemiologic study of ear and hearing disorders that was undertaken in Jiangsu Province, China. A question about tinnitus history was included in a comprehensive questionnaire about hearing. All participants also had both pure tone audiometry and an otological examination. The sample consisted of 6333 people 10 yr of age or older, selected by the methods of probability proportional to size. All participants answered a questionnaire concerning their tinnitus and had pure tone audiometry testing and an ear examination. All data were entered using EPIDATD 3.0 software and analyzed by a chi-squared test and test for trends. The overall prevalence of tinnitus was 14.5%, and the standardized rates were 11.4% in the whole country and 12.4% in Jiangsu province. Its prevalence increased with age. The prevalence of tinnitus was 11.9 and 15.6% in urban and rural residents, respectively There was no significant difference in prevalence between men and women. Hearing impairment, history of middle ear infections, and noise exposure were the main risk factors for tinnitus. Tinnitus is a common problem in the population. With the aging of the population, the prevalence of tinnitus will increase. The prevention of tinnitus should focus on hearing impairment screening, otitis media treatment, and noise exposure reduction. Health services in rural areas should emphasize prevention more.

The effects of an early history of otitis media on children's language and literacy skill development

Otitis media (OM) or middle ear infection is a common childhood illness and is most frequent during the crucial first 3 years of life when speech and language categories are being established, which could potentially have a long-term effect on language and literacy skill development. The purpose of the current study was to ascertain the effects of a history of OM in early childhood on later language and literacy skill development. Forty-three children from Grade 1 and Grade 2, between 6 and 8 years old with an early history of OM and 43 control children, matched for chronological age, gender and socio-economic status, participated in this study. Children were tested on multiple measures of phonological awareness, semantic knowledge, narration and reading ability. The performance of children with and without a history of OM was compared on the different measures. There was a general tendency for children with a history of OM to achieve lower scores on phonological awareness skills of alliteration, rhyme and non-word reading, semantic skills of expressive vocabulary and word definitions and reading than non-OM children. These findings highlight the potential problems an early history of middle ear infection can have on school-aged children's later language and literacy development.

Hearing loss in Turner syndrome

To address the characteristics of hearing loss in patients with Turner syndrome (TS), we evaluated hearing levels of patients with TS and analyzed causative factors. Thirty-three patients with TS (8 to 40 years of age) were studied through the use of audiological measurements, and causative factors were explored. Twenty cases (35 of 66 ears tested) showed high-frequency (8 kHz) sensory neural hearing loss (HFQ-SNHL). Fifteen cases (26 ears) and 15 cases (24 ears) of the impaired 20 cases were unresponsive to distortion-product otoacoustic emissions and transient-evoked otoacoustic emissions, respectively. HFQ-SNHL showed little relation to the history of middle ear infection and puberty, although middle ear infections were seen in 11 of the 20 cases. The hearing thresholds at high frequencies were correlated with age and body height (P < .001). The age-dependent increase in hearing thresholds in the high frequencies was more apparent in patients with TS with monosomic 45, X than in those with the mosaic type (P < .05). More than 60% of patients with TS had HFQ-SNHL. Because the increase in hearing threshold at high frequencies was shown to depend on karyotype and aging, regular otological examination is important for the determination of proper treatment.

Tympanometric Findings in Children at School Entry: A Normative Study

This study presents tympanometric normative data for Australian children at school entry in view of the lack of age-specific population-based data for this group. Participants were 327 children (164 boys, 163 girls) aged between 5 and 6 years, who had no history of middle ear infection, and passed pure-tone screening at 20 dB HL. Normative values for static admittance (SA), ear canal volume (ECV), tympanometric peak pressure, tympanometric width (TW) and tympanometric gradient were established. Based on these normative data, the use of the ASHA (1997) guidelines for medical referral, in which ECV > 1.0 ml in the presence of a flat tympanogram, SA 200 daPa may not provide the best criteria for Australian children aged between 5 and 6 years. If SA < 0.3 ml were used instead of SA < 0.16 ml, a greater proportion of Australian children would have failed tympanometry, thus increasing the false alarm rate.

IMPAIRED AUDITORY ATTENTION SKILLS FOLLOWING MIDDLE-EAR INFECTIONS

The present study investigated auditory attention skills in a sample of children with non-chronic otitis media with effusion (OME). Twenty children with repeated episodes of OME but not found in the need for myringotomy and insertion of ventilating tubes were compared to 20 control children with no known episodes of OME based on parental reports and medical records. Mean age during assessment was 9 years, and none of the children showed signs of impaired language functions and with normal general cognitive abilities. They were assessed with dichotic listening CV-syllables (DLCV-108) free recall and directed attention tasks. The control children showed the expected right ear advantage during free recall and the directed right condition, and demonstrated a shift toward a left ear advantage during the directed left. The children with a history of OME showed a predominant right ear advantage across all three tasks. Although some change in ear accuracy occurred across tasks, impaired auditory attention skills were found following a history of middle ear infections. These results replicate those reported earlier from a sample of children with persistent otitis media with effusion, and suggest that treatment with ventilating tubes does not appear to make any difference in the development of auditory attention skills, whereas occurrence of OME must be considered when testing auditory attentional skills as a part of a neuropsychological assessment. The writing of this report was facilitated with a grant from L. Meltzer Høyskolefond and financial support from the University of Bergen to Dr. Arve E. Asbjørnsen

High frequency hearing loss in Ullrich-Turner syndrome.

A total of 38 patients with Ullrich-Turner syndrome underwent standard otological and audiometric evaluation as well as high frequency audiological tests. Some 26 (68.4%) patients had a history of middle ear infections, and ten (26.3%) had required otolaryngological surgery. Conventional audiometry (125-8000 Hz) demonstrated normal hearing in only 25 of the ears (33%); between 500-4000 Hz, 16 ears (21.0%) had a mixed type and eight ears (10.5%) had conductive hearing loss. High frequency audiometry (8-18 kHz) revealed sensorineural hearing loss in 98.7% of the ears. Our results for conventional audiometry are in accordance with the literature. The detection of a high prevalence of hearing loss in the high frequency range brings a significant new perspective to the pursuit of the aetiology of ear and hearing problems in Ullrich-Turner syndrome. This pathology seems to be a premature variant of presbycusis and it may underlie future hearing impairment which will come to clinical attention only after it progresses to conventional testing frequencies. While further studies are underway to evaluate this aspect, routine otological and audiological follow-up of patients with Ullrich-Turner syndrome is warranted from the time of diagnosis.

Intracranial complications of ear disease in a pediatric population with special emphasis on subdural effusion and empyema.

Between the years 1963 to 1982, 84 consecutive cases of intracranial complications of ear disease in pediatric patients were diagnosed and treated at the North Carolina Baptist Hospital. This group consisted of 65 patients with otitic meningitis, four with otitic brain abscess, four with otitic hydrocephalus, three with lateral sinus thrombosis, three with otitic subdural empyemas, and five with an otitic subdural effusion of fluid. The advent of antibiotics has drastically altered the natural history of middle ear infections. We present these 84 cases to review diagnostic problems and therapeutic options, and to offer a plea for continued awareness of the middle ear as a potential source of central nervous system complications.