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Early Otitis Media with Effusion, Hearing Loss, and Auditory Processes at School Age

Gravel, Judith S.; Roberts, Joanne E.; Roush, Jackson; Grose, John; Besing, Joan; Burchinal, Margaret; Neebe, Eloise; Wallace, Ina F.; Zeisel, Susan

doi: 10.1097/01.aud.0000224727.45342.e9
Research Articles
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Objectives: To examine the effect of conductive hearing loss (HL) secondary to otitis media with effusion (OME) in the first 3 years of life on physiologic, peripheral, and higher-order behavioral auditory measures examined at school age.

Methods: Peripheral hearing sensitivity for conventional and extended high-frequency audiometric ranges, physiologic (distortion product otoacoustic emissions, contralateral and ipsilateral acoustic middle ear muscle reflexes), auditory brain stem response (ABR), and higher-order auditory processing measures (masking level difference; Virtual Auditory Localization, Speech Intelligibility Gain; adaptive Pediatric Speech Intelligibility task) were examined at the end of the second grade of elementary school in two cohorts (North Carolina, N = 73, and New York, N = 59). All participants (mean age, 8 years) were followed prospectively in infancy and early childhood (7 to 39 months) for middle ear status and hearing loss (using pneumatic otoscopy/tympanometry and repeated conditioned behavioral audiometric response procedures). Multivariate analyses were conducted to address whether early OME and early conductive HL were related to physiologic, peripheral, and higher-order auditory processes.

Results: Early hearing loss and OME were significantly associated with peripheral hearing at school age; extended high-frequency thresholds accounted for the result. Similarly, hearing loss in early life and OME were significantly associated with the acoustic middle ear muscle reflex: The contralateral stimulation condition accounted for the association. Significant associations with both early OME and early HL were also found for the auditory brain stem response measure and were explained by the correlations between early hearing loss and the ABR Wave V latency but not other ABR indices. There were no reliable associations between either early OME or early HL on any other auditory processes evaluated at the end of second grade.

Conclusions: Extended high-frequency hearing and brain stem auditory pathway measures in childhood were significantly associated with children’s experiences with OME and hearing loss from 7 to 39 months of age. However, no significant associations were found for psychoacoustic measures of binaural processing or a behavioral adaptive speech-in-noise test at school age.

Effects of conductive hearing loss (HL) secondary to otitis media with effusion (OME) in the first three years of life on physiologic, peripheral and higher-order behavioral auditory measures were examined at school age. Participants (mean age 8 years) in two cohorts from North Carolina and New York were followed prospectively in infancy and early childhood (7-39 months) for middle ear and hearing status. When examined at the end of 2nd grade, early HL and OME were significantly associated with peripheral hearing, acoustic middle ear muscle reflex, and auditory brain stem response measures. There were no reliable associations between either early OME or early HL on any other auditory processes including binaural and speech-in-noise measures.

Albert Einstein College of Medicine, Bronx, New York (J.S.G.); Frank Porter Graham Child Development Institute, Chapel Hill, North Carolina (J.E.R., M.B., E.N., S.Z.); the Department of Pediatrics and Division of Speech and Hearing Sciences, University of North Carolina at Chapel Hill (J.E.R., J.R.); Allied Medical Health, University of North Carolina, Chapel Hill (J.R.); the Department of Otolaryngology/HNS, University of North Carolina at Chapel Hill (J.G.); Montclair State University, Montclair, New Jersey (J.B.); and RTI, Research Triangle, North Carolina (I.F.W.).

Address for correspondence: Judith S. Gravel, PhD, Center for Childhood Communication, Children’s Seashore House, Room 113, The Children’s Hospital of Philadelphia, 3405 Civic Center Boulevard, Philadelphia, PA 19104. Email: gravel@email.chop.edu

Received August 25, 2004; accepted January 7, 2006.

© 2006 Lippincott Williams & Wilkins, Inc.