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Screening for hearing loss and middle-ear effusion in school-age children, using transient evoked otoacoustic emissions: a feasibility study

Published online by Cambridge University Press:  21 April 2008

C Georgalas*
Affiliation:
Department of Otolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
J Xenellis
Affiliation:
Academic Department of Otolaryngology, Hippocration Hospital, Athens, Greece
D Davilis
Affiliation:
Academic Department of Otolaryngology, Hippocration Hospital, Athens, Greece
A Tzangaroulakis
Affiliation:
Academic Department of Otolaryngology, Hippocration Hospital, Athens, Greece
E Ferekidis
Affiliation:
Academic Department of Otolaryngology, Hippocration Hospital, Athens, Greece
*
Address for correspondence: Dr Christos Georgalas, Department of Otolaryngology, Academisch Medisch Centrum, Postbus 22660, 1100 DD Amsterdam, The Netherlands. E-mail: [email protected]

Abstract

Introduction:

The characteristics of otoacoustic emissions that make them ideally suited for universal newborn hearing loss screening could potentially be useful for the screening of older children. This study was performed in order to assess the role of otoacoustic emissions in a screening programme for middle-ear disorders and hearing loss in school-age children.

Methods:

Cross-sectional, preliminary screening study.

Setting:

Primary schools of Argolida municipality, south-east Greece, between December 2004 and March 2005.

Patient selection and recruitment:

All the primary school students of Argolida were invited, by press releases and individually by their teachers, to attend a session of otological and audiological screening.

Results:

One hundred and ninety-six children were evaluated using transient evoked otoacoustic emissions. Twenty per cent failed in both ears, while in 32 per cent otoacoustic emissions could not be produced in at least one ear. Younger children had higher rates of absent transient evoked otoacoustic emissions. The absence of otoacoustic emissions was highly correlated with tympanic membrane changes seen on otoscopy and the presence of a type B tympanogram. As a single screening modality, otoacoustic emissions had a 100 per cent sensitivity in diagnosing hearing loss worse than 30 dB, and a 90 per cent sensitivity and 64 per cent specificity in diagnosing hearing loss worse than 25 dB, which did not improve by adding tympanometry to the screening protocol.

Conclusion:

These results strongly suggest the potential usefulness of otoacoustic emission testing in screening school-age children for hearing loss. Further studies, taking into account cost-effectiveness issues, are indicated.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2008

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References

1Kemp, DT. Stimulated acoustic emissions from within the human auditory system. J Acoust Soc Am 1978;64:1386–91CrossRefGoogle ScholarPubMed
2White, KR, Vohr, BR, Maxon, AB, Behrens, TR, McPherson, MG, Mauk, GW. Screening all newborns for hearing loss using transient evoked otoacoustic emissions. Int J Pediatr Otorhinolaryngol 1994;29:203–17CrossRefGoogle ScholarPubMed
3Gravel, J, Chobot, J, Liskow, C, Rose, F. Kennedy Centre, Albert Einstein College of Medicine: hearing and middle ear screening for older infants and toddlers. In: Roush, J, ed. Screening for Hearing Loss and Otitis Media in Children. San Diego: Singular Publishing, 2001;149–57Google Scholar
4Oudesluys-Murphy, AM, van Straaten, HLM, Bholasingh, R, van Zanten, GA. Neonatal hearing screening. Eur J Pediatr 1996;155:429–35CrossRefGoogle ScholarPubMed
5European Consensus Statement. European consensus statement on neonatal hearing screening. Scand Audiol 1998;27:259–60Google Scholar
6Weichbold, V, Nekahm-Heis, D, Welzl-Mueller, K. Universal newborn hearing screening and postnatal hearing loss. Pediatrics 2006;117:e631–6CrossRefGoogle ScholarPubMed
7New Zealand Health Technology Assessment. Screening Programmes for the Detection of Otitis Media With Effusion and Conductive Hearing Loss in Pre-school and New Entrant School Children: A Critical Appraisal of the Literature. Christchurch, New Zealand: New Zealand Health Technology Assessment, 1998;61Google Scholar
8Canadian Task Force on Preventive Health Care. Screening for otitis media with effusion: recommendation statement from the Canadian Task Force on Preventive Health Care. CMAJ 2001;165:1092–109Google Scholar
9Houghton, DJ, White, PS, Browning, GG. Predictors of outcome in children with otitis media with effusion. Clin Otolaryngol Allied Sci 1998;23:4850CrossRefGoogle ScholarPubMed
10MRC Multi-centre Otitis Media Study Group. Risk factors for persistence of bilateral otitis media with effusion. Clin Otolaryngol Allied Sci 2001;26:147–56CrossRefGoogle Scholar
11Rovers, MM, Black, N, Browning, GG, Maw, R, Zielhuis, GA, Haggard, MP. Grommets in otitis media with effusion: an individual patient data meta-analysis. Arch Dis Child 2005;90:480–5, 32CrossRefGoogle ScholarPubMed
12Xenellis, J, Paschalidis, J, Georgalas, C, Davilis, D, Tzagaroulakis, A, Ferekidis, E. Factors influencing the presence of otitis media with effusion 16 months after initial diagnosis in a cohort of school-age children in rural Greece: a prospective study. Int J Pediatr Otorhinolaryngol 2005;69:1641–7CrossRefGoogle Scholar
13Tos, M, Poulsen, G, Hancke, AB. Screening tympanometry during the first year of life. Acta Otolaryngol 1979;88:388–94CrossRefGoogle ScholarPubMed
14Kei, J, McPherson, B, Smyth, V, Latham, S, Loscher, J. Transient evoked otoacoustic emissions in infants: effects of gender, ear asymmetry and activity status. Audiology 1997;36:6171CrossRefGoogle ScholarPubMed
15Apostolopoulos, K, Xenelis, J, Tzagaroulakis, A, Kandiloros, D, Yiotakis, J, Papafragou, K. The point prevalence of otitis media with effusion among school children in Greece. Int J Pediatr Otorhinolaryngol 1998;44:207–14CrossRefGoogle ScholarPubMed
16Xenellis, J, Paschalidis, J, Georgalas, C, Davilis, D, Tzagaroulakis, A, Ferekidis, E. Factors influencing the presence of otitis media with effusion 16 months after initial diagnosis in a cohort of school-age children in rural Greece: a prospective study. Int J Pediatr Otorhinolaryngol 2005;69:1641–7CrossRefGoogle Scholar
17Driscoll, C, Kei, J, McPherson, B. Outcomes of transient evoked otoacoustic emission testing in 6-year-old school children: a comparison with pure tone screening and tympanometry. Int J Pediatr Otorhinolaryngol 2001;57:6776CrossRefGoogle ScholarPubMed
18Nozza, RJ, Sabo, DL, Mandel, EM. A role for otoacoustic emissions in screening for hearing impairment and middle ear disorders in school-age children. Ear Hear 1997;18:227–39CrossRefGoogle ScholarPubMed
19Driscoll, C, Kei, J, Bates, D, McPherson, B. Transient evoked otoacoustic emissions in children studying in special schools. Int J Pediatr Otorhinolaryngol 2002;64:5160CrossRefGoogle ScholarPubMed
20Meredith, R, Stephens, D, Hogan, S, Cartlidge, PHT, Drayton, M. Screening for hearing loss in an at-risk neonatal population using evoked otoacoustic emissions. Scand Audiol 1993;23:187193CrossRefGoogle Scholar
21Van Cauwenberge, PB, Vinck, B, De Vel, E, Dhooge, I. Tympanometry and click evoked otoacoustic emissions in secretory otitis media: are C-EOAE really consistently absent in type B tympanograms? In: Lim, DJ, Bluestone, CV, Casselbrant, M, Klein, JO, Ogra, PL, ed. Recent Advances in Otitis Media. Hamilton, Ontario: Decker, 1995;139–41Google Scholar
22Amedee, RG. The effects of chronic otitis media with effusion on the measurement of transiently evoked otoacoustic emissions. Laryngoscope 1995;105:589–95CrossRefGoogle ScholarPubMed