Otitis Media and Child Development

Abstract

Otitis media with effusion (OME) is the major cause of auditory dysfunction in preschool and early-grade schoolchildren. At especially high risk are children with cleft palate/lip; some groups of mentally retarded children; children from underprivileged communities and children with severe or profound sensorineural hearing loss. In neonates the major concern is to identify those with severe sensorineural hearing loss but awareness of the likelihood of OME is also vital. The hearing loss associated with OME in its early stages may be as small as 10–15 dB and in consequence conventional hearing tests employing pure tones are inadequate as screening procedures. Acoustic impedance testing has proved to be a practicable, acceptable, sensitive and efficient method of identification of OME in infants and children. Impedance measurement cannot, as yet, provide accurate assessment of hearing loss, but this is probably not a serious drawback. The primary requirement is to detect OME in order that swift and effective treatment can be instituted.

Longitudinal Study of Human Hearings: Its Relationship to Noise and Other Factors. 3. Results from the First Five Years

“…Each 50 mm of H20 decrease in middle ear pressure is associated with a change in AC thresholds of about 5 dB at low frequencies, and a change of about 2 to 3 dB at higher frequencies (Brooks, 1979).…”

“…Tympanography is a sensitive test for middle ear effusion being positive in 87 to 99% of true cases (Brooks, 1979), but otoscopy is less effective because of its high subjectivity (Northern, 1980). However, otoscopy in combination with tympanography is an effective method of identifying those children with middle ear problems.…”

“…This is to be expected because aural pathologies are often associated with elevated AC thresholds (Katz, 1978;Brooks, 1979;Lildhcldt w et al, 1980). This fact is also confirmed in the NCHS data (Roberts and Huber, 1970;Roberts and Ahuja, 1975) and in the Fels data (Roche et al, 1979).…”