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Deafness after otitis media in general practice
Insights
Routine hearing tests for children after acute otitis media are crucial. Persistent hearing loss and abnormal ear drum appearances warrant further specialist evaluation to ensure timely intervention.
Area of Science:
- Pediatrics
- Otolaryngology
- Audiology
Background:
- Acute otitis media (AOM) is a common childhood illness.
- Hearing loss can persist after AOM, impacting development.
- Early detection of hearing impairment is vital for children.
Purpose of the Study:
- To evaluate the effectiveness of routine audiometry in children post-AOM.
- To identify children with persistent hearing loss requiring further management.
- To assess the accuracy of clinical ear examination versus audiometry.
Main Methods:
- Forty-one children (4-10 years) with AOM underwent audiometry at 6 weeks.
- Children with abnormal tympanic membranes were specifically monitored.
- Follow-up audiometry at 3 months and referral criteria were established.
Main Results:
- Fifteen of 39 children failed the 6-week audiometry.
- Eight children had persistent hearing loss (≥30 dB) at 3 months and were referred.
- Abnormal tympanic membranes were linked to hearing loss in referred children.
Conclusions:
- Routine audiometry is recommended 6 weeks after AOM.
- Children with abnormal tympanic membranes require 3-month audiometry.
- Referral to ENT specialists is necessary for persistent hearing loss post-AOM.
Abstract:
Forty-one children between the ages of four and 10 years who presented with acute otitis media were offered routine audiometry six weeks after the attack. Fifteen of the 39 children who attended audiometry failed the test at six weeks, and eight children had a persistent hearing loss of 30 decibels (dB) or greater at three months and so were referred to an ENT specialist. In all these eight children an abnormal tympanic membrane had been detected before audiograms were seen. The mother's opinion of the child's hearing and the assessment by the doctor using tuning fork and whisper test were much less accurate. A total of 17 children had abnormal auroscopic appearances and 11 of these failed their first audiogram, eight failed the second and they were therefore referred.It is suggested that general practitioners should examine the ears of children six weeks after an attack of otitis media. Those children with abnormal tympanic membranes should undergo audiometry at three months, and those whose audiograms fail should then be referred.