Otoacoustic Emissions and Tympanometry Screening Among 0???5 Year Olds
Medical School, University of Minnesota, Minneapolis, USA. The Laryngoscope
(Impact Factor: 2.14).
03/2002; 112(3):513-9. DOI: 10.1097/00005537-200203000-00020
To determine the rate of otitis media (OM)-associated transient evoked otoacoustic emissions (TEOAE) screening failure in a sample of preschool children, to evaluate concordance between TEOAE and tympanometry, to investigate risk factors for TEOAE failure, and to determine agreement between TEOAE failure and physician findings at referral.
Children from birth to 5 years underwent screening by TEOAE and tympanometry, and those with one or more abnormal test result(s) were referred to their physician for further evaluation. Univariate associations between risk factors and TEOAE failure were determined using chi-square analysis. Multiple logistic regression analysis was done to examine the relationship between specific risk factors and TEOAE failure.
A total of 664 children aged 2 weeks to 71 months were screened between September 1997 and May 1999. TEOAE and tympanometry failure was found in 25% and 35% of all subjects, respectively. The overall prevalence of OM-associated hearing loss was 20%. Agreement between tympanometry and TEOAE was better for the youngest (<6 mo) and oldest > or =36 mo) age groups. Of those who failed TEOAE, a physician saw 81% within 3 months, and 80% of these had a diagnosis consistent with hearing loss but only 18% had audiometric testing. Sibling history of OM was the only significant predictor for TEOAE failure.
TEOAE screening failure was highly consistent with physician diagnosis at follow-up. Failure of TEOAE in a screening program should be followed with diagnostic audiology testing to determine whether conductive or sensorineural hearing loss is present.
Available from: Stephen Rich
- "Probands (defined as " individuals who had tympanostomy tube surgery for COME/ROM " ) and their families were recruited for the present study. In 2002, we began identifying probands from past and current studies conducted at the University of Minnesota Otitis Media Research Center between 1992 and 2001 (129 families) (Daly et al. 1996, 1999; Hunter et al. 1996; Ho et al. 2002) and from the general public (24 families). Of the 129 families recruited from previous studies, 82% of probands were ascertained from studies in which enrollment occurred at the time of tympanostomy tube treatment, 10% were from a prospective study of infants treated with tubes, and 8% were identified by a parent as having had tube treatment in a cross-sectional hearing-screening study. "
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ABSTRACT: Otitis media (OM) is the most common childhood disease. Almost all children experience at least one episode, but morbidity is greatest in children who experience chronic/recurrent OM (COME/ROM). There is mounting evidence that COME/ROM clusters in families and exhibits substantial heritability. Subjects who had tympanostomy tube surgery for COME/ROM (probands) and their families were recruited for the present study, and an ear examination was performed, without knowledge of the subject's history, to determine presence of OM sequelae. In addition, tympanometric testing was performed at three frequencies (226, 630 or 710, and 1,400 Hz) to detect abnormal middle-ear mechanics, and hearing was screened at 20 dB for the speech frequencies. Of these families, 121 had at least two individuals who had received the diagnosis of COME/ROM (364 affected and genotyped individuals), of whom 238 affected and informative relative pairs were used for analyses. Single-point nonparametric linkage analysis provided evidence of linkage of COME/ROM to chromosome 10q at marker D10S212 (LOD 3.78; P=3.0 x 10(-5)) and to chromosome 19q at marker D19S254 (LOD 2.61; P=5.3 x 10(-4)). Analyses conditional on support for linkage at chromosomes 10q and 19q resulted in a significant increase in LOD score support on chromosome 3p (between markers D3S4545 and D3S1259). These results suggest that risk of COME/ROM is determined by interactions between genes that reside in several candidate regions of the genome and are probably modulated by other environmental risk factors.
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