[Prevalence of conductive hypoacusis in children aged 5-9 years old from rural area in Poland--prospective screening of healthy subjects].Otolaryngol Pol. 2002; 56(4):459-66.OP
Otitis media with effusion (OME) is a process, which goes on by inner side of intact tympanic membrane. Oligosymptomatic and deceitful course is characteristics for this disease. Fluid filling middle ear structures causes long-lasting hypoacusis. Chronic consequences of the OME are morphologic changes within the middle ear, especially in the tense part of the tympanic membrane, causing strengthened conductive hypoacusis. The OME morbidity peak falls in 3-6 year of life, which is the period of the most intense development of the child and speech creation. Discreet symptoms, like fullness and feeling of fluid movement, not advanced hypoacusis, causes many problems in putting proper diagnosis. There should be aimed at quick detection of these symptoms, otherwise long persisting hypoacusis can have permanent negative influence on child's development. The aim of this study was to show the effectiveness of screening in population of children in their pre-elementary school and at the elementary school, focused on discreet pathology of the middle ear (OME) and low grade conductive hypoacusis. The study has a prospective character. Screening has covered a group of 927 children, aged 5-10. Examination concerned a population of healthy children, attending pre-elementary school and first classes of elementary school. Past otiatric history was the first step of diagnostic process, followed by full ENT examination and tympanometry. Special stress was laid on collecting medical history directed on the existence of discreet symptoms, like: low-grade hypoacusis manifested by some elements of child's behaviour (non responding on instructions, louder speaking, higher volume in TV-set), articulation disorders, difficulties in communication and problems at school. A group of 116 children actually presenting aural complaints lasting several weeks to several years were separated from the while examined group. Every 10th child from analyzed population submitted hypoacusis, 32 children had discreet symptoms, which allows to suspect hypoacusis. 330 children manifested otoscopic changes, which frequency was proportional to the time that aural symptoms have been lasting and correlate with other complaints, such as: allergy, rhinitis, sleep with open mouth, adenoidal hypertrophy. Pathological results of tympanometry was obtained in 23.3% of examined population, 16.6% made children, who neither actually, neither in anamnesis had ENT complaints. It is important to emphasize that age analysis in examined population shows directly that children in their 6th year of life are the group which should be comprised by screening on middle ear pathology.