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Endoscopic findings and long-term hearing results for pediatric unilateral conductive hearing loss
- Source :
- International journal of pediatric otorhinolaryngology. 133
- Publication Year :
- 2019
-
Abstract
- Objectives Analyze reasons for unilateral conductive hearing loss (CHL) with unknown etiology in children. Introduction Unilateral conductive hearing loss (HL) without known etiology can be undiagnosed despite of hearing screening programs. It can be difficult to find the reason for HL and to make a treatment plan. Middle ear endoscopy gives hard-evidence diagnosis and basis for an individual treatment plan. Methods and material Prospective clinical follow-up study for a cohort of generally healthy elementary school age children with unilateral conductive HL with unknown etiology. The study population was 192 children, of which 46 had a HL of at least 25 dB with more than 10 dB conductive component. Mean age was 8.7 years. Preoperative tests included otomicroscopy, bone- and air-conduction audiogram, tympanometry, stapes reflex tests, Rinne and Weber test and Otoacoustic emissions. The children underwent endoscopy of the middle ear with an individual treatment plan and long-term follow-up. The aim was to explore etiology and to give a treatment plan for hearing loss. Follow-up included air- and bone conduction hearing tests annually or every other year. Mean follow-up was 5.2 years. Results A clear etiological finding was found in 36 (78%) ears, stapes anomaly (23) as the most common (64%) finding. Other findings were two cholesteatomas, 2 status after trauma, 5 middle ear anomalies, 5 incus fixations and one incus erosion. Air conduction hearing improved spontaneously during follow-up in 81% (17/21, 2 dropouts) of the stapes anomaly ears (mean 11,3 dB, range 4–32 dB), and none of these ears showed hearing deterioration. In the incus fixation group, one ear showed hearing deterioration. There were no major complications for exploration, and 5 minor postoperative infections. Conclusions The most common reason for pediatric unilateral conductive hearing loss was stapes anomaly/fixation. The HL does not deteriorate. Hearing loss in stapes anomalies shows a tendency for spontaneous recovery. Stapes surgery can be postponed or avoided.
- Subjects :
- ANOMALIES
Male
medicine.medical_specialty
Adolescent
Hearing loss
Incus
Hearing Loss, Conductive
Ear, Middle
CHILDREN
Audiology
Hearing Loss, Unilateral
Conductive hearing loss
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Bone conduction
Audiometry
3123 Gynaecology and paediatrics
Weber test
030225 pediatrics
MANAGEMENT
otorhinolaryngologic diseases
medicine
Humans
3125 Otorhinolaryngology, ophthalmology
030223 otorhinolaryngology
Child
Stapes
Pediatric
medicine.diagnostic_test
business.industry
Endoscopy
General Medicine
Audiogram
Tympanometry
medicine.disease
Otorhinolaryngology
Child, Preschool
Pediatrics, Perinatology and Child Health
Female
medicine.symptom
business
Middle-ear
MIDDLE
Subjects
Details
- ISSN :
- 18728464 and 01655876
- Volume :
- 133
- Database :
- OpenAIRE
- Journal :
- International journal of pediatric otorhinolaryngology
- Accession number :
- edsair.doi.dedup.....6772a3c313d9694cb99abb1f86e1461d