Medical Treatment of Otitis Media: The Pediatrician's Point of View

Effect of Temporal Area Bone Vibrator Placement on Auditory Brain Stem Response in Newborn Infants*

“…Residual fluid in the middle ear cavity of the newborn infant (Proctor, 1964) and the high incidence of otitis media with effusion in at-risk infants in neonatal intensive care units (Balkany, Berman, Simmons, & Jafek, 1978;de Sa, 1973;McLellan, Strong, Johnson, & Dent, 1962;Paradise, 198 1) have been suggested as possible contributors to ABR abnormalities (Cox, Hack, & Metz 1982;Hall et al, 1988, Simmons, 1982Yang, Rupert, & Moushegian, 1987). As otoscopic examination is difficult Groothius, 1982;Schreiner & Kisling, 198 1) and tympanometry unreliable with newborns (Paradise, Smith, & Bluestone, 1979;Schwartz & Schwartz, 1978), the challenge of differentiating sensorineural from conductive hearing loss and thus reducing initial failure rate in ABR screening remains.…”

Auditory Brain Stem Responses to Air- and Bone-Conducted Clicks in the Audiological Assessment of At-Risk Infants

“…The high incidence of middle ear effusion among neonatal intensive care unit infants (Balkany, Berman, Simmons, & Jafek, 1978;Derkay, Bluestone, Thompson, Stephenson, & Kardtzke, 1988;McLellan, Strong, Johnson, & Dent, 1962;Paradise, 1981;Proctor & Kennedy, 1990; Stockard & Curran, 1990) and the presence of residual substance and fluid in the middle ear cavity of newborn infants (Buch & Jorgensen, 1964;Proctor, 1964) have been suggested as potential contributors to the so called "inaccuracy" in ABR newborn auditory screening. Unfortunately, the conventional indices for detecting middle ear pathology such as otoscopic examination and tympanometry have proven to be difficult in the case of the former Groothius, 1982;Schreiner & Kiesling, 1981) and unreliable in the latter (Paradise, Smith, & Bluestone, 1979;Schwartz & Schwartz, 1978) with newborn infants. What remains, therefore, is the continuing challenge of distinguishing between ABR abnormalities due to conductive versus sensorineural losses in neonates.…”