Identifying factors associated with spontaneous restoration of hearing in children with otitis media with effusion
Identifying factors associated with spontaneous restoration of hearing in children with otitis media with effusion
Objectives: To identify predictors of acceptable hearing at 5 weeks, 6 and 12 months in children with bilateral otitis media with effusion (OME). Design and setting: Secondary analysis of OSTRICH data, conducted in hospital ear, nose and throat (ENT) and paediatric audiology and audiovestibular medicine departments across Wales and England. Participants: The OSTRICH study included 389 children aged 2-8 years with bilateral hearing loss attributable toOME for at least 3 months. Main outcome measures: Baseline, 5-week, 6- and 12-month audiology measurements were collected and logistic regression models used to identify pre-randomisation baseline variables that predicted return of acceptable hearing, which was defined as less than or equal to 20 dB hearing loss averaged within the frequencies of 0.5, 1, 2 and 4 kHz in at least one ear in children assessed by pure tone audiometry, ear-specific insert visual reinforcement audiometry or ear-specific play audiometry less than or equal to 25 dB hearing loss averaged within the frequencies of 0.5, 1, 2 and 4 kHz in children assessed by sound-field visual reinforcement audiometry or sound-field performance/play audiometry, based on national guidelines. Results: Less severe baseline hearing loss across both ears most consistently predicted acceptable hearing at 5 weeks (adjusted odds ratio [aOR] 0.91, 95% CI 0.87-0.95), 6 months (0.94 [0.90-0.98]) and 12 months (0.93 [0.89-0.97]). Negative history of atopy (2.05 [1.16-3.61]), never using hearing aids (aOR 2.16 [1.04-4.48]), and being male (1.75 [1.02-2.99]) were significant at 6 months, but not at 12 months. Symptom duration was a predictor at 5 weeks, but not at 6 or 12 months. Conclusions: Milder baseline hearing loss most consistently predicts acceptable hearing at 5 weeks, 6 and 12 months in children with chronic OME. Negative history of atopy, never using hearing aids, and male gender are associated with better prognosis. These predictors can be used to identify children that may not require treatment.
child, chronic otitis media, ear, nose and throat, hearing aids, otitis media, otitis media with effusion, research
243-248
Edwards, Lowri
7bbbec07-395b-4394-ac61-9e5e8d300688
Cannings-John, Rebecca
f45c9562-b1d0-4c6d-9c7c-8f27cd3e47cd
Butler, Christopher
8bf4cace-c34a-4b65-838f-29c2be91e434
Francis, Nick
9b610883-605c-4fee-871d-defaa86ccf8e
January 2021
Edwards, Lowri
7bbbec07-395b-4394-ac61-9e5e8d300688
Cannings-John, Rebecca
f45c9562-b1d0-4c6d-9c7c-8f27cd3e47cd
Butler, Christopher
8bf4cace-c34a-4b65-838f-29c2be91e434
Francis, Nick
9b610883-605c-4fee-871d-defaa86ccf8e
Edwards, Lowri, Cannings-John, Rebecca, Butler, Christopher and Francis, Nick
(2021)
Identifying factors associated with spontaneous restoration of hearing in children with otitis media with effusion.
Clinical Otolaryngology, 46 (1), .
(doi:10.1111/coa.13654).
Abstract
Objectives: To identify predictors of acceptable hearing at 5 weeks, 6 and 12 months in children with bilateral otitis media with effusion (OME). Design and setting: Secondary analysis of OSTRICH data, conducted in hospital ear, nose and throat (ENT) and paediatric audiology and audiovestibular medicine departments across Wales and England. Participants: The OSTRICH study included 389 children aged 2-8 years with bilateral hearing loss attributable toOME for at least 3 months. Main outcome measures: Baseline, 5-week, 6- and 12-month audiology measurements were collected and logistic regression models used to identify pre-randomisation baseline variables that predicted return of acceptable hearing, which was defined as less than or equal to 20 dB hearing loss averaged within the frequencies of 0.5, 1, 2 and 4 kHz in at least one ear in children assessed by pure tone audiometry, ear-specific insert visual reinforcement audiometry or ear-specific play audiometry less than or equal to 25 dB hearing loss averaged within the frequencies of 0.5, 1, 2 and 4 kHz in children assessed by sound-field visual reinforcement audiometry or sound-field performance/play audiometry, based on national guidelines. Results: Less severe baseline hearing loss across both ears most consistently predicted acceptable hearing at 5 weeks (adjusted odds ratio [aOR] 0.91, 95% CI 0.87-0.95), 6 months (0.94 [0.90-0.98]) and 12 months (0.93 [0.89-0.97]). Negative history of atopy (2.05 [1.16-3.61]), never using hearing aids (aOR 2.16 [1.04-4.48]), and being male (1.75 [1.02-2.99]) were significant at 6 months, but not at 12 months. Symptom duration was a predictor at 5 weeks, but not at 6 or 12 months. Conclusions: Milder baseline hearing loss most consistently predicts acceptable hearing at 5 weeks, 6 and 12 months in children with chronic OME. Negative history of atopy, never using hearing aids, and male gender are associated with better prognosis. These predictors can be used to identify children that may not require treatment.
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More information
Accepted/In Press date: 27 September 2020
e-pub ahead of print date: 4 October 2020
Published date: January 2021
Additional Information:
Funding Information:
The OSTRICH trial was funded by the National Institute for Health Research Health Technology Assessment programme (reference 11/01/26). The secondary analysis of data did not require further funding.
Funding Information:
The views expressed are those of the authors and not necessarily those of the NHS, the National Institute for Health Research, or the UK Department of Health and Social Care. The Centre for Trials Research is funded by the Welsh Assembly Government through Health and Care Research Wales and the authors gratefully acknowledge the contribution of Centre for Trials Research to study implementation. We thank all the children and families who participated in the trial, without whom this trial would not have been possible. We thank staff at the local National Institute for Health Research Clinical Research Networks and the Health and Care Research Wales Workforce and staff involved at our participating sites, including principal investigators, ENT consultants and specialist registrars, audiologists, clinic staff, research nurses, research coordinators, and administrators.
Publisher Copyright:
© 2020 John Wiley & Sons Ltd
Keywords:
child, chronic otitis media, ear, nose and throat, hearing aids, otitis media, otitis media with effusion, research
Identifiers
Local EPrints ID: 444325
URI: http://eprints.soton.ac.uk/id/eprint/444325
ISSN: 1749-4478
PURE UUID: 3490fa2c-ade9-4499-bd37-ff46891b79a5
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Date deposited: 13 Oct 2020 16:38
Last modified: 17 Mar 2024 03:58
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Contributors
Author:
Lowri Edwards
Author:
Rebecca Cannings-John
Author:
Christopher Butler
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