Objectives
To study the extent to which otitis media in childhood is associated with adult hearing thresholds. Furthermore, to study if the effects of otitis media on adult hearing thresholds are moderated by age or noise exposure.
Design
Population-based cohort study of 32,786 participants who had their hearing tested by pure-tone audiometry in primary school and again at ages ranging from 20–56 years. 3066 children were diagnosed with hearing loss, the remaining sample had normal childhood hearing.
Results
Compared to participants with normal childhood hearing, those diagnosed with childhood hearing loss caused by otitis media with effusion (n=1255), chronic suppurative otitis media (n=108) or hearing loss after recurrent acute otitis media (n=613) had significantly reduced adult hearing thresholds in the whole frequency range (2 dB/17–20 dB/7–10 dB, respectively). The effects were adjusted for age, sex and noise exposure. Children diagnosed with hearing loss after recurrent acute otitis media had somewhat improved hearing thresholds as adults. The effects of chronic suppurative otitis media and hearing loss after recurrent acute otitis media on adult hearing thresholds were larger in participants tested in middle adulthood (ages 40 to 56 years) than in those tested in young adulthood (ages 20 to 40 years). Eardrum pathology added a marginally increased risk of adult hearing loss (1–3 dB) in children with otitis media with effusion or hearing loss after recurrent acute otitis media. Our study could not reveal significant differences in the effect of self-reported noise exposure on adult hearing thresholds between the groups with otitis media and the group with normal childhood hearing.
Conclusions
This cohort study indicates that chronic suppurative otitis media and recurrent acute otitis media in childhood are associated with adult hearing loss, underlining the importance of optimal treatment in these conditions. It appears that ears with a subsequent hearing loss after otitis media in childhood age at a faster rate than those without, however this should be confirmed by studies with several follow-up tests through adulthood.