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Paping DE, Oosterloo BC, El Marroun H, Homans NC, Baatenburg de Jong RJ, van der Schroeff MP, Vroegop JL. Risk Factors For Hearing Decline From Childhood To Early Adolescence. Laryngoscope 2023; 133:389-395. [PMID: 35587728 PMCID: PMC10084436 DOI: 10.1002/lary.30207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 05/01/2022] [Accepted: 05/02/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To identify risk factors of hearing decline between 9 and 13 years of age. The risk factors examined included sociodemographic, health, and lifestyle-related factors. METHODS This study was embedded within a population-based prospective cohort study from fetal life onwards in the Netherlands. Pure-tone audiometry and tympanometry were performed at the age of 9 and 13 years. The hearing decline was defined as an increase in low-frequency or high-frequency pure-tone average of at least 5 dB in one of both ears. Multivariable logistic regression was performed to examine the association of possible risk factors with hearing decline. The study was conducted from April 2012 to October 2015, and from April 2016 to September 2019. RESULTS Of the 3,508 participants included, 7.8% demonstrated a hearing decline in the low frequencies, and 11.3% in the high frequencies. Participants who reported alcohol consumption were more likely to have a hearing decline in the low frequencies (OR 1.5, 95% CI 1.1; 2.0). Moreover, a lower educational level was associated with an increased odds of having a hearing decline in the high frequencies (OR 1.4, 95% CI 1.0; 1.8). Age, sex, household income, personal music player use, and body mass index were not associated with hearing decline. CONCLUSION Educational level and risky behavior were significantly associated with hearing decline from childhood to early adolescence. The findings of the present study can help in the design of public health interventions to prevent hearing loss at a young age. LEVEL OF EVIDENCE 2 (prospective cohort study) Laryngoscope, 133:389-395, 2023.
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Affiliation(s)
- Danique E Paping
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.,The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Berthe C Oosterloo
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.,The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Hanan El Marroun
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Psychology, Education and Child Studies, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Nienke C Homans
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Rob J Baatenburg de Jong
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Marc P van der Schroeff
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands.,The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Jantien L Vroegop
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
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Abstract
OBJECTIVES The pathogenesis of chronic suppurative otitis media (CSOM) includes complex interactions between microbial, immunologic, and genetic factors. To our knowledge, no study has focused on the association between childhood otitis media, immune regulation, inflammatory conditions, and chronic disease in adulthood. The present study aims to assess whether CSOM in childhood predicts immune-related inflammatory disorders or cardiovascular disease in adulthood. Another aim is to assess the association with oto-vestibular diseases in adulthood. DESIGN Population cohort study in Norway comprised 51,626 participants (mean age 52 years) who underwent a hearing investigation at 7 to 13 years of age where 189 were diagnosed with CSOM (otorhinolaryngologist diagnose) and 51,437 had normal hearing thresholds (controls). Data on adult disease were obtained from the Norwegian Patient Registry (ICD-10 codes from the specialist health services). We estimated associations with logistic regression analyses. RESULTS The associations between CSOM in childhood and disease in adulthood were as follows: chronic sinusitis (odds ratio 3.13, 95% confidence interval 1.15 to 8.52); cardiovascular disease (1.38, 1.01 to 1.88); hearing loss (5.58, 3.78 to 8.22); tinnitus (2.62, 1.07 to 6.41). The adult hearing loss among cases with childhood CSOM was most frequently registered as sensorineural. There was no statistically significant increased risk of later asthma (1.84 [0.98 to 3.48]), inflammatory bowel disease, inflammatory joint disease, systemic tissue disease, or vestibulopathy. The estimates were adjusted for age, sex, socio-economic status, and smoking. CONCLUSION Our large cohort study, which is the first to focus on the link between otitis media in childhood and immune-related inflammatory disorders later in life, does not confer a clear association. CSOM in childhood was strongly related to adult tinnitus and hearing loss, which was most frequently registered as sensorineural.
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le Clercq CMP, van Ingen G, Ruytjens L, Goedegebure A, Moll HA, Raat H, Jaddoe VWV, Baatenburg de Jong RJ, van der Schroeff MP. Prevalence of Hearing Loss Among Children 9 to 11 Years Old: The Generation R Study. JAMA Otolaryngol Head Neck Surg 2017; 143:928-934. [PMID: 28750130 DOI: 10.1001/jamaoto.2017.1068] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Importance Hearing loss (HL), a major cause of disability globally, negatively affects both personal and professional life. Objective To describe the prevalence of sensorineural hearing loss (SNHL) among a population-based cohort of 9- to 11-year-old children, and to examine potential associations between purported risk factors and SNHL in early childhood. Design, Setting, and Participants The study was among the general, nonclinical, pediatric community within the city of Rotterdam, the Netherlands, and was conducted between 2012 and 2015 as a cross-sectional assessment within the Generation R Study, a population-based longitudinal cohort study from fetal life until adulthood. Participants are children of included pregnant women in the Generation R Study with an expected delivery date between April 2002 and January 2006. They form a prenatally recruited birth cohort. Main Outcomes and Measures Pure-tone air-conduction hearing thresholds were obtained at 0.5, 1, 2, 3, 4, 6, and 8 kHz, and tympanometry was performed in both ears. Demographic factors and parent-reported questionnaire data, including history of otitis media, were also measured. Results A total of 5368 participants with a mean age of 9 years 9 months (interquartile range, 9 years 7 months-9 years 11 months) completed audiometry and were included in the analyses. A total of 2720 were girls (50.7%), and 3627 (67.6%) were white. Most of the participants (4426 children [82.5%]) showed normal hearing thresholds 15 dB HL or less in both ears. Within the cohort, 418 children (7.8%) were estimated to have SNHL (≥16 dB HL at low-frequency pure-tone average; average at 0.5, 1, and 2 kHz or high-frequency pure-tone average; average at 3, 4, and 6 kHz in combination with a type A tympanogram) in at least 1 ear, most often at higher frequencies. In multivariable analyses, a history of recurrent acute otitis media and lower maternal education were associated with the estimated SNHL at ages 9 to 11 years (odds ratio, 2.0 [95% CI. 1.5-2.8] and 1.4 [95% CI, 1.1-1.7], respectively). Conclusions and Relevance Within this cohort study in the Netherlands, 7.8% of the children ages 9 to 11 years had low-frequency or high-frequency HL of at least 16 dB HL in 1 or both ears. A history of recurrent acute otitis media and lower maternal education seem to be independent risk factors for presumed SNHL in early childhood.
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Affiliation(s)
- Carlijn M P le Clercq
- Department of Otolaryngology-Head and Neck Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.,The Generation R Study Group, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Gijs van Ingen
- Department of Otolaryngology-Head and Neck Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.,The Generation R Study Group, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Liesbet Ruytjens
- Department of Otolaryngology-Head and Neck Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - André Goedegebure
- Department of Otolaryngology-Head and Neck Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Henriette A Moll
- The Generation R Study Group, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Hein Raat
- The Generation R Study Group, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Rob J Baatenburg de Jong
- Department of Otolaryngology-Head and Neck Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Marc P van der Schroeff
- Department of Otolaryngology-Head and Neck Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.,The Generation R Study Group, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
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Daly KA, Rovers MM, Hoffman HJ, Uhari M, Casselbrant ML, Zielhuis G, Kvaerner KJ. 1. Epidemiology, Natural History, and Risk Factors. Ann Otol Rhinol Laryngol 2016; 194:8-15. [PMID: 15700931 DOI: 10.1177/00034894051140s104] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Kathleen A Daly
- Department of Otolaryngology, University of Minnesota, Minneapolis, USA
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Abstract
OBJECTIVES To study the extent to which otitis media (OM) in childhood is associated with adult hearing thresholds. Furthermore, to study whether the effects of OM on adult hearing thresholds are moderated by age or noise exposure. DESIGN Population-based cohort study of 32,786 participants who had their hearing tested by pure-tone audiometry in primary school and again at ages ranging from 20 to 56 years. Three thousand sixty-six children were diagnosed with hearing loss; the remaining sample had normal childhood hearing. RESULTS Compared with participants with normal childhood hearing, those diagnosed with childhood hearing loss caused by otitis media with effusion (n = 1255), chronic suppurative otitis media (CSOM; n = 108), or hearing loss after recurrent acute otitis media (rAOM; n = 613) had significantly increased adult hearing thresholds in the whole frequency range (2 dB/17-20 dB/7-10 dB, respectively). The effects were adjusted for age, sex, and noise exposure. Children diagnosed with hearing loss after rAOM had somewhat improved hearing thresholds as adults. The effects of CSOM and hearing loss after rAOM on adult hearing thresholds were larger in participants tested in middle adulthood (ages 40 to 56 years) than in those tested in young adulthood (ages 20 to 40 years). Eardrum pathology added a marginally increased risk of adult hearing loss (1-3 dB) in children with otitis media with effusion or hearing loss after rAOM. The study could not reveal significant differences in the effect of self-reported noise exposure on adult hearing thresholds between the groups with OM and the group with normal childhood hearing. CONCLUSIONS This cohort study indicates that CSOM and rAOM in childhood are associated with adult hearing loss, underlining the importance of optimal treatment in these conditions. It appears that ears with a subsequent hearing loss after OM in childhood age at a faster rate than those without; however this should be confirmed by studies with several follow-up tests through adulthood.
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Vasconcellos AP, Kyle ME, Gilani S, Shin JJ. Personally Modifiable Risk Factors Associated with Pediatric Hearing Loss: A Systematic Review. Otolaryngol Head Neck Surg 2014; 151:14-28. [PMID: 24671457 PMCID: PMC4472569 DOI: 10.1177/0194599814526560] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 02/12/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Pediatric hearing loss is an increasingly recognized problem with significant implications. Increasing our quantitative understanding of potentially modifiable environmental risk factors for hearing loss may form the foundation for prevention and screening programs. OBJECTIVE To determine whether specific threshold exposure levels of personally modifiable risk factors for hearing loss have been defined, with the overarching goal of providing actionable guidance for the prevention of pediatric hearing loss. DATA SOURCES A systematic review was performed. Computerized searches of PubMed, EMBASE, and the Cochrane Library were completed and supplemented with manual searches. REVIEW METHODS Inclusion/exclusion criteria were designed to determine specific threshold values of personally modifiable risk factors on hearing loss in the pediatric population. Searches and data extraction were performed by independent reviewers. RESULTS There were 38 criterion-meeting studies, including a total of 50,651 subjects. Threshold noise exposures significantly associated with hearing loss in youth included: (1) more than 4 hours per week or more than 5 years of personal headphone usage, (2) more than 4 visits per month to a discotheque, and (3) working on a mechanized farm. Quantified tobacco levels of concern included any level of in utero smoke exposure as well as secondhand exposure sufficient to elevate serum cotinine. CONCLUSIONS Specific thresholds analyses are limited. Future studies would ideally focus on stratifying risk according to clearly defined levels of exposure, in order to provide actionable guidance for children and families.
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Hassmann-Poznańska E, Goździewski A, Piszcz M, Zajaczkiewicz H, Skotnicka B. [Influence of tympanic membrane changes on immittance and extended frequency audiometric findings]. Otolaryngol Pol 2011; 64:307-12. [PMID: 21166142 DOI: 10.1016/s0030-6657(10)70612-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The aim of the study is to analyze the relationship between otoscopic tympanic membrane abnormalities, results of impedanace and extended-high-frequency audiometry in subjects with history of treatment of secretory otitis media (SOM) and ventilation tube insertion. MATERIAL AND METHODS 97 subjects treated because of SOM were examined in years 1999-2000. Videootoscopic examinations, extended-high-frequency audiometry and tympanometry with ispilateral acoustic reflex were performed in each patient. The results were analysed in three groups: no otoscopic abnormalities (BZO), retraction pockets (KR) and atrophy and myringosclerosis (AM). The results were compared to otologicaly healthy control group in the same age. RESULTS The most common tympanic membrane abnormality were focal atrophy (64.7%) of ears and myringosclerosis (37.2%). Mean pure-tone audiometric threshold were significantly higher in groups KR and AM than in control and BZO groups. Low degree of positive correlation was found between the presence of myringosclerosis and atrophy and audiometric thresholds above 1 kHz. No such correlation was observed with the presence of retraction pockets. In the BZO group middle ear admittance was observed significantly higher than in control group. The absent ipsilateral stapedial reflex was observed in 10.8% ears in BZO group, 16.9% in AM and 33.3% in KR. No correlation was found between the parameters of tympanometric evaluation and results of extended-high-frequency audiometry. CONCLUSIONS In ears treated because of SOM with ventilation tube insertion the middle ear compliance is higher. In the presence of myringosclerosis and atrophy higher audiometric thresholds are observed. Tympanic membrane abnormalities have been more clearly indicated by the absent ipsilateral stapedial reflex than tympanometry.
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Martínez-Wbaldo MDC, Soto-Vázquez C, Ferre-Calacich I, Zambrano-Sánchez E, Noguez-Trejo L, Poblano A. Sensorineural hearing loss in high school teenagers in Mexico City and its relationship with recreational noise. CAD SAUDE PUBLICA 2010; 25:2553-61. [PMID: 20191147 DOI: 10.1590/s0102-311x2009001200003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2008] [Accepted: 09/03/2009] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to measure the frequency of hearing loss in a sample of typical public high-school students exposed to recreational noise, and determine associated risk factors. The sample was made up of 214 teenagers from a high-school in Mexico City; subjects were selected randomly per strata. We applied a questionnaire to identify risk factors for hearing loss and performed a battery of audiologic tests consisting of otoscopy, tympanometry, and pure-tone audiometry. The mean age of the sample was 16 +/- 1.07 years; 73% were male and 27%, female. Hearing loss was found in 21% of students. The main hearing loss-related risk factor was exposure to recreational noise: frequent attendance at discotheques and pop-music concerts; use of personal stereos; and noise exposure in school workshops. The high frequency of hearing loss in high school students from one Mexico City school (nearly one fifth of the sample) was found to be related to noise exposure mainly during recreational activities.
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Tajima-Pozo K, Zambrano-Enriquez D, De Anta L, Zelmanova J, De Dios Vega JL, Lopez-Ibor JJ. Otitis and autism spectrum disorders. BMJ Case Rep 2010; 2010:2010/may06_1/bcr1020092351. [PMID: 22736729 DOI: 10.1136/bcr.10.2009.2351] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
The case of a 5-year-old child diagnosed as having pervasive developmental disorder (PDD), autistic type, from age 1 is reported. After surgery of vegetation in middle ear for repetitive otitis, the child presented an improvement in autistic behaviours, previously expressed as impaired social interactions, qualitative abnormalities in communication, a marked delay in language development, echolalia, stereotypies and self-aggressive behaviours. The aim of this paper is to bring attention to occurrences of misdiagnosis of PDD, which can occur when an adequate screening of the autistic syndrome is not realised. The result of the surgery was an improvement in autistic behaviours, despite the persistence of less severe autistic traits that may be more closely related to Asperger's syndrome.
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Ferreira MDS, Almeida KD, Atherino CCT. Limiares de audibilidade em altas freqüências em crianças com história de otite média secretora bilateral. ACTA ACUST UNITED AC 2007. [DOI: 10.1590/s0034-72992007000200014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Existem achados na literatura de limiares elevados em altas freqüências em crianças com história de otite média secretora. OBJETIVO: Caracterizar os limiares de audibilidade nas altas freqüências em crianças normo-ouvintes com história de múltiplos episódios de otite média secretora bilateral. MATERIAL E MÉTODO: Constituiu-se uma amostra de 31 crianças de ambos os sexos, sendo 14 com até 3 episódios de otite média secretora bilateral (Grupo 1) e 17 com quatro ou mais episódios (Grupo 2). Foi realizada a audiometria tonal por via aérea para as freqüências de 9.000 a 18.000Hz. FORMA DE ESTUDO: Transversal prospectivo. RESULTADOS: Não houve diferença entre os limiares de audibilidade das orelhas direitas e esquerdas dos indivíduos de ambos os grupos para todas as freqüências, porém, houve entre os limiares de audibilidade das orelhas direitas e esquerdas do Grupo 2 em relação ao Grupo 1 para todas as freqüências avaliadas. CONCLUSÕES: 1- Houve uma elevação dos limiares de audibilidade com o aumento das freqüências apresentadas. 2- A audiometria de altas freqüências mostrou-se capaz de separar, em grupos, indivíduos com história de otite média secretora denotando que quatro episódios de otite média já são suficientes para determinar diferenças estatisticamente significantes nos limiares de audibilidade das altas freqüências.
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Affiliation(s)
| | - Katia de Almeida
- Universidade Federal de São Paulo; Santa Casa de São Paulo; Universidade Veiga de Almeida
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Ferreira MDS, de Almeida K, Atherino CCT. Audibility threshold for high frequencies inchildren with medical history of multiples episodes of bilateral secretory otitis media. Braz J Otorhinolaryngol 2007; 73:231-8. [PMID: 17589732 PMCID: PMC9450627 DOI: 10.1016/s1808-8694(15)31071-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2006] [Accepted: 05/09/2006] [Indexed: 11/26/2022] Open
Abstract
UNLABELLED Relatively poorer audibility threshold for high frequency was found in children with medical history of multiples episodes of secretory otitis media. AIM to characterize the audibility threshold for high frequencies in normal-hearing children with medical history of multiples episodes of bilateral secretory otitis media. MATERIALS AND METHODS a sample of 31 children, from both genders, was divided in two groups: 14 subjects who had not more than 3 episodes of bilateral secretory otitis media (Group 1) and 17 subjects that experienced at least 4 episodes of this condition (Group 2). Pure-tone air conduction audiometry was tested at frequencies 9,000 to 18,000 Hz. STUDY DESIGN transversal prospective. RESULTS there was no difference between audibility thresholds comparing right and left ears of subjects of both Group 1 and Group 2 in all tested frequencies. However, there was difference between audibility thresholds between subjects of Group 2 compared to Group 1 in all tested frequencies. CONCLUSION 1- There was an increase in audibility thresholds with the increase in frequency . 2- High frequency audiometry separates subjects with history of at least four episodes of secretory otitis media, suggesting that these episodes are sufficient to promote statistically significant difference in high frequency thresholds.
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Rabinowitz PM, Slade MD, Galusha D, Dixon-Ernst C, Cullen MR. Trends in the Prevalence of Hearing Loss Among Young Adults Entering An Industrial Workforce 1985 to 2004. Ear Hear 2006; 27:369-75. [PMID: 16825886 DOI: 10.1097/01.aud.0000224125.12338.9a] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Studies have suggested that hearing loss due to recreational noise exposure may be on the rise among adolescents and young adults. This study examines whether the hearing status of young US adults entering an industrial workforce has worsened over the past 20 yr. DESIGN The baseline audiograms of 2526 individuals ages 17 to 25 beginning employment at a multisite US corporation between 1985 and 2004 were analyzed to determine the yearly prevalence of hearing loss. RESULTS Approximately 16% of the young adults in the sample had high frequency hearing loss (defined as hearing thresholds greater than 15 dB in either ear at 3,4, or 6 kHz). In a linear regression model, this prevalence decreased over the 20-yr period (odds ratio (OR) = 0.96, 95% confidence interval (CI): 0.94, 0.99). Almost 20% of subjects had audiometric "notches" consistent with noise exposure; this rate remained constant over the 20 yr, as did the prevalence (5%) of low frequency hearing loss. CONCLUSIONS These results indicate that despite concern about widespread recreational noise exposures, the prevalence of hearing loss among a group of young US adults has not significantly increased over the past two decades.
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Affiliation(s)
- Peter M Rabinowitz
- Yale University School of Medicine, Occupational and Environmental Medicine Program, New Haven, Connecticut, USA
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De Beer BA, Schilder AGM, Zielhuis GA, Graamans K. Natural course of tympanic membrane pathology related to otitis media and ventilation tubes between ages 8 and 18 years. Otol Neurotol 2006; 26:1016-21. [PMID: 16151352 DOI: 10.1097/01.mao.0000185058.89586.ed] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To present the course of tympanic membrane pathology in childhood and young adulthood after otitis media (OM) in early life. STUDY DESIGN Prospective follow-up study. SETTING Community study of a birth cohort. PATIENTS Three hundred fifty-eight subjects with a positive and negative history of OM (OM+ or OM-) or ventilation tube insertion (VT+ or VT-) derived from a birth cohort that had been followed-up from preschool to adult age. METHODS Standardized otomicroscopic examination performed at ages 8 and 18 years. MAIN OUTCOME MEASURES Tympanic membrane abnormalities (i.e., tympanosclerosis, atrophy, atelectasis and retraction pockets of the pars tensa, and retraction of the pars flaccida). RESULTS At the age of 8 years, tympanic membrane pathology was highly prevalent in the both OM+ subcohorts (OM+VT+, 92% and OM+VT-, 46%), whereas in the OM- ears (11%), tympanic membrane abnormalities were rare. In the subsequent 10-year period, many tympanic membrane abnormalities disappeared spontaneously, although the prevalence of tympanosclerosis remained substantial in the OM+VT+ cohort. CONCLUSION The natural course of most tympanic membrane pathology associated with OM in early life is favorable over time, suggesting an intrinsic repair capacity of the tympanic membrane. Tympanosclerosis, the most prevalent sequelae of OM and treatment with VT, however, shows little tendency of resolution.
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Affiliation(s)
- B A De Beer
- Department of Otorhinolaryngology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
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Augustsson I, Engstrand I. Hearing ability according to screening at conscription; comparison with earlier reports and with previous screening results for individuals without known ear disease. Int J Pediatr Otorhinolaryngol 2006; 70:909-13. [PMID: 16297451 DOI: 10.1016/j.ijporl.2005.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2005] [Accepted: 10/06/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE (1) To study if young, Swedish men have poorer or better hearing according to screening at conscription in 1988 compared to 1969-1977. (2) To study how the results of screening and audiometry vary across the teenage years for a group of boys without middle ear disease. METHOD A birth cohort has earlier been well documented regarding results in four general screenings with follow-up and examinations and treatment for middle ear disease at the ENT departments in the area. Their results when screened at conscription have been compared with those in earlier reports on screening of Swedish conscripts. We have also studied results in screenings and follow-up at 11 and 14 years of age with special focus on small losses at the frequencies of 3, 4, 6 and 8 kHz and describe how 611 boys without known ear disease performed in these examinations and in screening at the age of 18. RESULTS There is no obvious trend in the prevalence of hearing loss in Swedish conscripts. At 11 years of age 80.4% and at 14 years of age 64.6% of small high tone losses diagnosed by screening were not confirmed by audiometry. Approximately half of those who had confirmed losses had normal screening at conscription. CONCLUSIONS 18-year-old Swedish boys did not have poorer hearing in 1998 than 29 years earlier. Information drawn from screenings must be interpreted with caution.
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Affiliation(s)
- Ingrid Augustsson
- Department of Otorhinolaryngology, Orebro University Hospital, S-70185 Orebro, Sweden.
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Herrero-Morín JD, Concha Torre JA, Fernández González N, Crespo Hernández M. [Hypoacusis after the neonatal period. Situations requiring hearing assessment]. An Pediatr (Barc) 2005; 63:502-8. [PMID: 16324615 DOI: 10.1016/s1695-4033(05)70249-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Because hearing plays a major role in language development, pediatric hypoacusis is especially damaging. The high frequency of hearing impairment in newborns and the need for an early diagnosis have led to the establishment of neonatal screening. Nevertheless, there are other situations which may compromise hearing quality in later stages and it is essential to identify them in order to be able to provide early and effective treatment. OBJECTIVES To describe the most frequent reasons for referring patients for hearing evaluation to a third level hospital and to identify common situations that require hearing assessment among the pediatric population. PATIENTS AND METHODS The clinical histories of 197 non-neonates evaluated for hypoacusis were reviewed. Clinical parameters and diagnosis were compared in patients with impaired and normal hearing. RESULTS One hundred sixty-one patients had no previous known hypoacusis. The main reason for evaluation was suspicion by the family or child minder (53.4 %), followed by language underdevelopment. In the first examinations 78 children had hypoacusis (48.4 %), which was more frequently bilateral than unilateral. In 29.5 % of hypoacusic patients, the disease was related to recurrent otitis or adenoiditis and in 25.6 % it was genetic. The most frequent antecedent was deaf relatives in hypoacusic patients and abnormal phenotypes in children with normal hearing. Three patients with previous bacterial meningitis were studied and two of these had hypoacusis. CONCLUSIONS Hypoacusic evaluation outside the context of newborn screening is mainly motivated by clinical suspicion of hypoacusis or language underdevelopment. Other situations such as recurrent otitis with effusion, syndromic phenotypic characteristics or bacterial meningitis are related to hearing problems and therefore require detailed evaluation.
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Affiliation(s)
- J D Herrero-Morín
- Departamento de Pediatría, Centro Materno-Infantil. Hospital Universitario Central de Asturias, Oviedo, Spain.
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Weichbold V, Rohrer M, Winkler C, Welzl-Müller K. Hörscreening an Kindergärten: Ergebnisse einer Evaluierungsstudie. Wien Klin Wochenschr 2004; 116:478-83. [PMID: 15379143 DOI: 10.1007/bf03040943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study aimed to evaluate the hearing screening of pre-school children at nursery schools in Tyrol, Austria. METHODS AND SAMPLE 47 nursery schools with a total of 2199 enrolled children participated in the study. At the screening, the children were presented a series of tones at frequencies 0.5 kHz (25dB), 1 kHz, 2 kHz, 3 kHz, and 4 kHz (20 dB each) from portable audiometers. The tones were presented over headphones for each ear separately and at irregular intervals. Failure to respond to any of the frequencies was considered failure of the screening. Parents were then advised in written form to have the child examined by an ENT-specialist. RESULTS 1832 individuals were screened (coverage: 83% of nursery school children; corresponding to at least 63% of all Tyrolean children aged 3 to 5 years). Of these, 390 failed the test (referral rate: 21% of all screened). Examination through an ENT-specialist occurred with 217 children, and this confirmed the positive test in 139 children (hit rate: 64%). In most cases, a temporary conductive hearing loss due to external or middle ear problems (glue ear, tube dysfunction, cerumen, otitis media) was diagnosed. A sensorineural hearing loss was found in 4 children (in 3 of them bilateral). The need for therapy was recognized in 81 children (4% of all screened). CONCLUSION Pre-school hearing screening identifies children with ear and hearing problems that need therapeutical intervention. Although the hearing problems are mostly of a temporary nature, some may require monitoring over some period. Also some children with permanent sensorineural hearing loss may be detected through this measure. Hearing screening is an efficient means of assessing ear and hearing problems in pre-school children. However, the follow-up rate needs to be improved for optimizing the efficacy.
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Affiliation(s)
- Viktor Weichbold
- Klinische Abteilung für Hör-, Stimm- und Sprachstörungen, Medizinische Universität Innsbruck, Innsbruck, Osterreich.
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