Audiologic Profiles of Children With Otitis Media With Effusion.
Sarah Al-Salim, Richard M Tempero, Hannah Johnson and 1 others
PMID 33974785WHAT IT FOUND
The volume of fluid in the middle ear drives hearing loss severity in children with otitis media.
Full effusions cause moderate hearing loss and absent otoacoustic emissions, while partial effusions result in milder loss. Tympanometry cannot distinguish these volumes or predict hearing status.
Key findings
01Ears with full effusions showed moderate hearing loss and very few measurable otoacoustic emissions, whereas ears with partial effusions or clear middle ears had slight to mild hearing loss and more measurable emissions.
02Tympanometry was unable to reliably differentiate effusion volumes or provide an indication of hearing status, as all ears with confirmed effusions had type B tympanograms regardless of volume.
03Even when the middle ear appeared clear of fluid at surgery, children with recent otitis media performed poorer on all audiologic tests than healthy controls, suggesting lingering pathological effects.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study had limited variability in effusion viscosity and purulence, preventing analysis of their specific effects. Effusion characteristics were assessed subjectively by the surgeon, introducing potential misclassification. Bone conduction thresholds could not be obtained for many young participants, relying on air conduction and OAEs to rule out sensorineural loss. The sample size was small (27 children in the OME group).
Declared interests
The authors declared no conflicts of interest. The study was supported by the National Institute on Deafness and Other Communication Disorders (N.I.H.).
The easy way to misread this
Do not assume that a Type B tympanogram indicates a full effusion or moderate hearing loss. Tympanometry cannot distinguish between partial and full effusions, so it should not be used alone to estimate the degree of hearing loss or functional impact on listening.