Middle ear measures as predictors of hearing loss in Australian aboriginal schoolchildren

This study sought to establish the value of tympanometry and otoscopy for predicting significant conductive hearing loss in remote-area Aboriginal children, and also to measure the range of hearing loss which can be expected with middle ear disease, with or without a tympanic membrane (TM) perforation. A field study is reported of 255 Aboriginal children aged up to 16 years who were examined with pneumotoscopy and tympanometry and whose hearing was tested under controlled acoustic conditions. Results showed that pneumatic otoscopy for detection of middle ear effusion and identification of perforations resulted in the best rate of prediction of significant conductive hearing loss. Furthermore, the hearing of children with perforated TMs (mean pure-tone average 30.0 dB; S.D. 11.1) was significantly worse than those in which tympanometry suggested middle ear effusion (mean pure-tone average 20.3 dB; S.D. 9.6), and both differed significantly from ears showing normal tympanograms (mean pure-tone average 11.2 dB; S.D. 5.9). Implications for community-based hearing screening and classroom management of affected children are discussed.