Screening for middle ear disease in a school for the deaf

Area of Science:

• Audiology
• Otolaryngology
• Pediatric Medicine

Background:

• Middle ear effusion (MEE) and high negative middle ear pressure (HNP) are common conditions affecting hearing.
• Understanding these conditions in deaf populations is crucial for auditory management and development.
• The Western Pennsylvania School for the Deaf (WPSD) provided a unique setting to study these issues in profoundly deaf students.

Purpose of the Study:

• To determine the incidence of middle ear effusion in profoundly deaf students.
• To investigate the correlation between high negative middle ear pressure and middle ear effusion.
• To assess the impact of high negative middle ear pressure on auditory acuity in this population.

Main Methods:

• A year-long study involving 446 profoundly deaf students at WPSD.
• Screenings included otoscopy and tympanometry conducted three times annually.
• Monthly evaluations for 41 students with HNP and 41 controls assessed middle ear status and auditory acuity.

Main Results:

• Prevalence rates: 8% MEE, 21% HNP, 1% inactive disease, 26% residual disease, 44% normal middle ear status.
• Younger children (2-8 years) experienced the majority of severe middle ear problems.
• HNP alone did not reliably predict MEE in older students (6-21 years); only 21% of HNP ears normalized compared to 77% of control ears.

Conclusions:

• High negative middle ear pressure is a persistent issue in profoundly deaf students, with a significant proportion not returning to normal.
• While a direct correlation with effusion was difficult to establish in older students, HNP's persistence suggests potential long-term middle ear health concerns.
• Further research is needed to fully understand the impact of HNP on auditory function in deaf children, though increased threshold fluctuation was observed.