RESUMEN
Because at present no estimated data is available concerning the frequency of hearing loss in the population of primary school children in Silesia, it has been assumed useful to carry out a research programme. An important advantage of this study is the assessment of hearing in children from Upper Silesian region, a top ranking region in Europe in industrialisation and environmental pollution. In the selected population of primary school children in the province of Silesia, hearing loss occurred in 6% of the examined pupils; in schools located in urban areas it was higher than in schools from rural areas. In the group of children aged 6-10 years conductive hearing loss occurred significantly more frequently, than main cause of that hearing loss was Eustachian tube dysfunction. The obtained results testify about the society being hardly aware of the problems related to hearing loss, which stresses the necessity of conducting screening examinations of hearing organ in children at school age, as well as improving the health care and prevention in that respect.
Asunto(s)
Contaminación Ambiental/efectos adversos , Pérdida Auditiva Conductiva/diagnóstico , Pérdida Auditiva Conductiva/epidemiología , Tamizaje Masivo/métodos , Pruebas de Impedancia Acústica , Adolescente , Distribución por Edad , Análisis de Varianza , Niño , Estudios Transversales , Femenino , Pérdida Auditiva/diagnóstico , Pérdida Auditiva/epidemiología , Pruebas Auditivas/métodos , Humanos , Incidencia , Masculino , Polonia/epidemiología , Probabilidad , Medición de Riesgo , Población Rural/estadística & datos numéricos , Servicios de Salud Escolar , Distribución por Sexo , Población Urbana/estadística & datos numéricosRESUMEN
The aim of this study was analysis of results of audiologic evaluation in the group of 191 children with hearing loss. Children were selected from the group of 8885 pupils of primary schools in Silesia by screening test "Slysze" in 2002. Universal Screening Program of Hearing in Children and Teenage "Slysze" was created and introduced in to the clinic practice by Institute of Physiology and Pathology of Hearing in Warsaw in 1999. The screening program consists of: pure tone examination and speech audiometry in noise. Children with hearing loss detected by this test in 2002 were followed laryngological and audiological examination. Special attention was paid on articulation disturbances, communicational and educational problems in children with hearing loss. The authors focused also attention on "discreet signs of hearing deficiency" (not reacting to commands, turning up a TV-set, loud speech). The validation of screening test "Slysze" was also conducted. In the selected population of primary schoolchildren in Silesia hypoacusis occurred in 6% of examined children, in "city" schools the percentage proved to be higher than in "village" schools. In the group aged 6 to 10 the conductive hearing loss occurred considerable more frequently. Eustachian tube dysfunctions in children with conductive hearing loss occurred more frequently in the group of the younger ones. Older than 10 years old in most cases proved to have perceptive-type of hearing loss. The hearing loss hinders a child's psycho-intellectual development, it is important to detect it as early as possible. The evaluations showed that despite frequent occurrence of "discreet symptoms of hypoacusis", only 17.8% of parents suspected hearing loss in their own child. According to the frequency of parents' signals of "discreet symptoms of hypoacusis" it was found that the fact of turning up TV sound was the most powerful sign indicating the probability of hearing loss (45.5%). The most common risk factors of hearing loss in schoolchildren were also estimated. A characteristic, homogenous group of 34 children (17.8%) was the group with MSHL minimal sensorineral hearing loss of high frequencies (6-8 kHz). Results obtained give evidence of low level of awareness in the society concerning the problem of hypoacusis, which confirms the necessity to screening of hearing in schoolchildren and improving of health care in this respect. Diagnosing hypoacusis in case of children is an interdisciplinary problem, requiring cooperation of medical circles but also teachers, speech therapists and parents.
Asunto(s)
Pérdida Auditiva Conductiva/epidemiología , Pérdida Auditiva de Alta Frecuencia/epidemiología , Pérdida Auditiva Provocada por Ruido/epidemiología , Tamizaje Masivo , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Pruebas de Impedancia Acústica , Adolescente , Trastornos de la Articulación/diagnóstico , Trastornos de la Articulación/epidemiología , Audiometría de Tonos Puros/métodos , Causalidad , Niño , Comorbilidad , Femenino , Pérdida Auditiva Conductiva/diagnóstico , Pérdida Auditiva de Alta Frecuencia/diagnóstico , Pérdida Auditiva Provocada por Ruido/diagnóstico , Humanos , Masculino , Otitis Media con Derrame/diagnóstico , Otitis Media con Derrame/epidemiología , Padres , Polonia/epidemiología , PrevalenciaRESUMEN
INTRODUCTION: The measure of efficaciency of screening test is specificality and sensitivity. The validation of the screening test by using Program "Slysze" in Silesia in year 2002 was done. MATERIAL AND METHODS: The Program consisted of two parts: 1. The screening test in schools: a) pure-tone test, b) speech audiometry in noice, and 2. Audiometric verifying of "positive results" of the test. 8885 children were tested in Silesia in 2002. 919 schoolchildren (10.3%) had "positive results". 465 pupils reported to a verifying examination. The hearing loss was confirmed in 191 children. 6 months after the end of Program the control audiometric examinations to validate the Program "Slysze" were done in 100 children, who gained "negative results" in screening test. RESULTS: Program "Slysze" had a high specificality--0.93, sensitivity--0.70, ability to identify--0.92. A positive predictive value was--0.40, and negative predictive value was--0.98.
Asunto(s)
Audiometría del Habla , Pérdida Auditiva/diagnóstico , Audición/fisiología , Tamizaje Masivo/métodos , Niño , Femenino , Humanos , Masculino , Polonia , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad , Estudios de Validación como AsuntoRESUMEN
UNLABELLED: Paralysis of the facial nerve reveales some symptoms which are very unfavourable for esthetic point of view (deformity of the face with incompetence of the palpebal function). It is recognized as the one of the most invalidity for humane life. There are many surgical techniques to reconstructive facial nerve such as: decompression, end to end or side to end anastomosis with hypoglosal, glosopharyngeal, axesorius or mandibular nerves. Reconstruction technique depends upon the extent of injury, the availability of the proximal stump and time since injury and duration of muscle denervation. In the presence of facial paralysis electrodiagnostic tests should be performed before surgery and every 3 mounts after, during rehabilitation, which play also the most important role in recovery. MATERIAL AND METHODS: The authors present the outcome of the surgical treatment of the facial nerve paresis in 31 patients cured in the Silesian Department of Laryngology in Katowice from 1991 to 2002. The reasons of the paresis were otitis media with cholesteatoma and granuloma in 18 cases, head trauma in 2 patients and iatrogenic impairment after ear operations in 11 cases. The decompression of the facial nerve was done in 20 patients, anastomosis end to end in 3, crossover anastomoses between the facial nerve and the hypoglossal nerve was done in 1 case, and transplantation of auricular major nerve in 7 cases. RESULTS: The outcome was good in 20 patients (64.5%), satisfactory in 10 patients (32.3%) and non satisfactory in one case (3.2%). CONCLUSION: In our material the most of cases was caused by otitis media with cholesteatoma. The best outcome was obtained after decompression of the facial nerve. The rehabilitation before and after surgery play the very important role in the recovery.