Audiometric thresholds and auditory processing in children with early malnutrition: a retrospective cohort study
Patricia Aparecida Zuanetti1, Maria Fernanda Laus2, Adriana Ribeiro Tavares Anastasio3
1Department of Ophthalmology, Otorhinolaryngology and Head and Neck, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, Brazil.
Insights
Early childhood malnutrition is linked to impaired auditory processing in children, though not outright hearing loss. This study highlights the critical impact of early nutrition on hearing development and function.
Area of Science:
- Otorhinolaryngology
- Developmental Pediatrics
- Neuroscience
Background:
- Malnutrition can alter cellular metabolism, impacting high-metabolism organs like the inner ear.
- Early-life nutrition is crucial for developing sensory systems, including auditory pathways.
Purpose of the Study:
- To investigate the association between early childhood malnutrition and auditory processing deficits.
- To determine if malnutrition correlates with hearing abnormalities in children.
Main Methods:
- A retrospective cohort study involving 45 children, categorized into malnutrition, learning difficulties, and control groups.
- Auditory assessments included tympanometry, pure-tone audiometry, and the Staggered Spondaic Word (SSW) test for auditory processing.
- Statistical analysis employed Kruskal-Wallis and equality of proportion tests.
Main Results:
- No participants exhibited hearing deficiencies.
- Children with a history of malnutrition showed lower hearing thresholds at multiple frequencies.
- 100% of children with early malnutrition presented auditory processing abnormalities, significantly higher than control groups.
Conclusions:
- Early malnutrition leads to reduced hearing levels, but not overt hearing deficiency.
- Auditory processing abilities are significantly impaired in children with a history of early malnutrition.
Context And Objective:
Malnutrition is one of the causes of changes in cell metabolism. The inner ear has few energy reserves and high metabolism. The aim of this study was to analyze whether malnutrition at an early age is related to impairment of auditory processing abilities and hearing abnormalities.
Design And Setting:
Retrospective cohort study conducted in a tertiary public hospital.
Methods:
45 children participated, divided as follows: G1, children diagnosed with malnutrition in their first two years of life; G2, children without history of malnutrition but with learning difficulties; G3, children without history of malnutrition and without learning difficulties. Tympanometry, pure-tone audiometry and the Staggered Spondaic Word (SSW) test (auditory processing) were performed. Statistical inferences were made using the Kruskal-Wallis test (α = 5%) and the test of equality of proportions between two samples (α = 1.7%).
Results:
None of the 45 children participating in this study presented hearing deficiencies. However, at six of the eight frequencies analyzed, the children in G1 presented hearing thresholds lower than those of the other groups. In the auditory processing evaluation test, it was observed that 100% of the children in G1 presented abnormal auditory processing and that G1 and G2 had similar proportions of abnormalities (P-values: G1/G2 = 0.1; G1/G3 > 0.001; G2/G3 = 0.008).
Conclusions:
Malnutrition at an early age caused lowering of the hearing levels, although this impairment could not be considered to be a hearing deficiency. Every child in this group presented abnormalities in auditory processing abilities.
