RESUMEN
The incidence and persistence of middle ear effusion (MEE) may be affected by children's birth history and environment. Factors such as bottle-feeding, presence of parental smoking, admission to special care and a history of colds are all thought to increase the risk of persistent MEE. The aim of the present study was to determine those risk factors and neonatal test results that best predict presence of MEE (as measured by 220 Hz tympanometry) at 8 months of age. One hundred Special Care Baby Unit (SCBU) and non-SCBU babies were assessed neonatally and at 8 months of age with tympanometry. At each assessment, various risk factors were collected. Failure of 8-month tympanometry was best predicted by neonatal (660 Hz) tympanometry and the presence or absence of breast-feeding for SCBU babies. This provides further evidence that 660 Hz tympanometry may provide information about neonatal MEE. For non-SCBU babies the risk of failing 8-month tympanometry was most significantly affected by a history of colds and parental smoking. The number of babies with each combination of risk factors in the present study is rather small and this has caused confidence intervals (CIs) to be wide and some unexpected results. However, an extended study with a larger and more balanced sample may facilitate accurate prediction neonatally of those children at risk of 8-month MEE.
Asunto(s)
Tamizaje Neonatal , Otitis Media con Derrame/diagnóstico , Pruebas de Impedancia Acústica , Femenino , Humanos , Recién Nacido , Masculino , Ocupaciones , Otitis Media con Derrame/epidemiología , Padres , Valor Predictivo de las Pruebas , Prevalencia , Reflejo Acústico/fisiología , Factores de Riesgo , Fumar/efectos adversos , Encuestas y CuestionariosRESUMEN
The aim of this study was to compare aspects of visual reinforcement audiometry (VRA) and the distraction test (DT), the two most commonly used behavioural tests of hearing for young children. The number of assessments completed, time taken, parental opinion and levels of minimum responses were compared in a group of 20 infants (mean age 17.7 months; SD 4.7 months; range 12-25 months) who had been selected from those referred from a local second-tier community audiology service. Each infant was assessed with each test following set protocols and a balanced design on two occasions separated by one week. Parental opinion was determined by application of two questionnaires, one after each session. There was no difference in the number of minimum response levels (MRLs) measured by the two tests. However, if a VRA protocol using three MRLs was assumed then the assessment was completed successfully in a significantly greater number of subjects with VRA. VRA took, on average, two minutes less than the DT to measure six MRLs. Most of the subject sample had normal hearing as defined by both tests. However, where MRLs were >30 dB HL for at least one of the tests, the DT elicited responses at significantly higher levels than VRA, suggesting that in these subjects the DT under-estimated hearing sensitivity. Seventy per cent of parents selected VRA when asked to choose between the tests.