Determinants of sensorineural hearing loss in chronic middle-ear disease

Sensorineural Hearing Loss in Unilateral Mucosal Type of Chronic Otitis Media

Sensorineural hearing loss is relatively well established in the squamosal chronic otitis media. However, its association with mucosal COM is still debated. The present study aimed at evaluating the prevalence of sensorineural hearing loss in unilateral mucosal COM. The study was conducted at a tertiary care hospital in New Delhi, and 60 patients with unilateral mucosal chronic otitis media were recruited. Pure tone thresholds were ascertained for air and bone conduction in an acoustically treated room and matched against certain patient and disease characteristics. In this study, the combined prevalence of SNHL/Mixed Hearing loss in mucosal COM was found to be 8.3%. A statistically significant association between SNHL/Mixed HL was seen in the 40-50-year age group (p-0.004). Prevalence with a disease duration of more than 10 years was 33% (p-0.019). All the patients who presented with SNHL/Mixed HL had an actively discharging ear. 80% of the patients who presented with SNHL/Mixed HL had large perforations. SNHL/Mixed HL prevalence of 28.6% was found in smokers, compared to 5.7% in non-smokers (p-0.039). The risk of developing SNHL/Mixed HL increased with increasing patients' age, disease duration, and size of the perforation and smokers.

Otitis Media and Its Association With Hearing Loss in Chinese Adults: A Population Based Study of 4 Provinces in China

Objective

Otitis media is a recognized cause of significant hearing loss, particularly in developing countries. This study aimed to investigate the relationship between otitis media and hearing loss in Chinese adults aged 18 years and older.

Methods

The survey was based on WHO Ear and Hearing Disorders Survey Protocol and 36,783 adults at the ages between 18 years and above were selected in this study. Trained local examiners performed pure tone audiometry to screen people with hearing loss, and those who were screened positively for hearing loss were referred to audiologists to make final diagnosis. All participants underwent clinical ENT check-up and otoscopic examination by doctors trained in ENT. Each participant was assigned a single middle ear diagnosis. Diagnoses were assigned as per the WHO classification of ear and hearing disorders.

Results

Logistic regressions showed that higher prevalence of hearing loss was found in participants with otitis media, with an unadjusted odds ratio of 5.67 (95%CI: 4.66, 6.90). The next two models (Model 2–3) had slight impact on ORs. The interaction of residency and otitis media was statistically significant (OR = 1.70, 95%CI = 1.15, 2.53); otitis media patients in rural areas had higher risk of hearing loss. However, this interaction became not significant in 65 years old and above participants.

Conclusions

Otitis media was associated with the risk of hearing loss. Compared with urban patients with otitis media, rural patients have the higher risk of hearing loss. Action to reduce the risk of hearing loss in otitis media will require attention to rural-urban disparities.

Chronic Otitis Media and its Correlation with Unilateral Sensorineural Hearing Loss in a Tertiary Care Centre of North India

Relation between chronic otitis media and sensorineural hearing loss is controversial. Otitis media can cause threshold shift in high frequency range. Also this correlation with patient's age, disease duration and normal ear is of importance for early prevention of hearing loss. The aim of this study was to evaluate relationship between sensorineural hearing loss and chronic otitis media. We also studied association of bone conduction between diseased ear and contralateral normal ear. In this study, 840 patients of unilateral COM were included. Audiometry was done and data analyzed. Majority of patients showing SNHL had COM for over a period of 5 years. Squamosal disease showed early progression to SNHL than mucosal disease. Higher frequencies were found to be more affected and maximum bone gap was seen at 4000 Hz. There was significant difference in mean bone conduction threshold between diseased ear and normal ear at all frequencies (p value < 0.001). Contradicting studies have emerged about association of SNHL with COM. Studies suggest that SNHL does not change with age but with duration. Bone conduction threshold tends to increase with increasing frequency. Few authors also pointed that this may be due to Carhart's effect and not due to disease damaging inner ear.

Comparison of chronic suppurative otitis media in rural and urban primary school children in Bangladesh

Objectives:

To compare chronic suppurative otitis media prevalence in rural and urban primary school children in Bangladesh, and to determine its relationship with specific sociodemographic factors.

Methods:

In this cross-sectional survey, 681 rural primary school children from Shibpur upazilla, Narsingdi district, and 964 urban primary school children from Dhaka Metropolitan City, underwent an ENT check-up by doctors trained in ENT. Their parents or guardians were interviewed with regard to their sociodemographic status and other related issues using a pre-tested protocol.

Results:

In this study, 6.02 per cent of the rural primary school children and 2.07 per cent of the urban primary school children had chronic suppurative otitis media. (Overall, 3.71 per cent of the children had the disorder.) The disorder was slightly more prevalent among girls than boys in both rural (6.05 vs 5.98 per cent) and urban (2.33 vs 1.82 per cent) communities. There was a significant association between the presence of chronic suppurative otitis media in children and: parents' or guardians' occupation and their annual income, housing type, family size, maternal education, and bathing habit.

Conclusion:

Improvement of associated sociodemographic factors would reduce the prevalence and resultant complications of chronic suppurative otitis media in primary school children in developing countries.

Chronic suppurative otitis media and its association with socio-econonic factors among rural primary school children of bangladesh

Chronic Suppurative Otitis Media (CSOM) is a common community health disorder of children in all developing countries like Bangladesh which causes significant impact in speech, cognitive, educational and psychological development. The aim of the study was to determine the prevalence of CSOM and its association with certain socio-economic factors and health related practice and believes among rural primary school children of Bangladesh. The study was done among 1468 rural school going children (Boys:Girls, 1:1.23) aged between 4 and 12 years (mean 8.8 ± 1.66) in five randomly selected rural primary school of Palash Upazilla of Narsingdi district, Bangladesh. They had underwent ENT check up by the doctors trained in ENT and their guardians were interviewed regarding their socioeconomic status, health related practices and beliefs and other related issues using a pre tested protocol. Total 77 (5.2%) cases of CSOM were detected with girl's predominance (5.7 vs. 4.7%). Our study revealed statistically significant association of CSOM with yearly income of guardian (P < 0.005), maternal education (P < 0.001), bathing habit (P < 0.001), ear cleaning habit (P < 0.05), pattern of primary medical consultation (P < 0.05). Disease prevalence was also found higher among the dwellers of kachha house. So, this preventable burning problem of CSOM can be resolved by collective effort by incorporating primary ear care program with primary health care system among the vulnerable children of rural area along with their socio-economic development. Thus, future citizens can be safeguarded from developing CSOM, hearing impairment and its resultant complications.