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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
Identifying factors associated with spontaneous restoration of hearing in children with otitis media with effusion
Objectives To identify predictors of acceptable hearing at five-weeks, six- 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 two to eight years with bilateral hearing loss attributable to OME for at least three months.

Main outcome measures Baseline, five-week, six- 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 five-weeks (adjusted odds ratio [aOR] 0.91, 95% CI 0.87 to 0.95), six-months (0.94 (0.90 to 0.98)), and 12 months (0.93 (0.89 to 0.97)). Negative history of atopy (2.05 (1.16 to 3.61)), never using hearing aids (aOR 2.16 (1.04 to 4.48)), and being male (1.75 (1.02 to 2.99)) were significant at six-months, but not at 12 months. Symptom duration was a predictor at five-weeks, but not at six- or 12 months.

Conclusions Milder baseline hearing loss most consistently predicts acceptable hearing at five-weeks, six-months 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
1749-4478
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
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 (2020) Identifying factors associated with spontaneous restoration of hearing in children with otitis media with effusion. Clinical Otolaryngology, 46 (1), 243-248. (doi:10.1111/coa.13654).

Record type: Article

Abstract

Objectives To identify predictors of acceptable hearing at five-weeks, six- 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 two to eight years with bilateral hearing loss attributable to OME for at least three months.

Main outcome measures Baseline, five-week, six- 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 five-weeks (adjusted odds ratio [aOR] 0.91, 95% CI 0.87 to 0.95), six-months (0.94 (0.90 to 0.98)), and 12 months (0.93 (0.89 to 0.97)). Negative history of atopy (2.05 (1.16 to 3.61)), never using hearing aids (aOR 2.16 (1.04 to 4.48)), and being male (1.75 (1.02 to 2.99)) were significant at six-months, but not at 12 months. Symptom duration was a predictor at five-weeks, but not at six- or 12 months.

Conclusions Milder baseline hearing loss most consistently predicts acceptable hearing at five-weeks, six-months 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
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
ORCID for Nick Francis: ORCID iD orcid.org/0000-0001-8939-7312

Catalogue record

Date deposited: 13 Oct 2020 16:38
Last modified: 10 Jan 2022 03:19

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Contributors

Author: Lowri Edwards
Author: Rebecca Cannings-John
Author: Christopher Butler
Author: Nick Francis ORCID iD

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