Endoscopic findings and long-term hearing results for pediatric unilateral conductive hearing loss

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Silvola, J T 2020, ' Endoscopic findings and long-term hearing results for pediatric unilateral conductive hearing loss ', International Journal of Pediatric Otorhinolaryngology, vol. 133, 109983 . https://doi.org/10.1016/j.ijporl.2020.109983

Title: Endoscopic findings and long-term hearing results for pediatric unilateral conductive hearing loss
Author: Silvola, Juha Tapio
Contributor organization: Päijät-Häme Welfare Consortium
HYKS erva
Date: 2020-06
Language: eng
Number of pages: 5
Belongs to series: International Journal of Pediatric Otorhinolaryngology
ISSN: 0165-5876
DOI: https://doi.org/10.1016/j.ijporl.2020.109983
URI: http://hdl.handle.net/10138/315736
Abstract: Objectives: Analyze reasons for unilateral conductive hearing loss (CHL) with unknown etiology in children. Introduction: Unilateral conductive hearing loss (HL) without known etiology can be undiagnosed despite of hearing screening programs. It can be difficult to find the reason for HL and to make a treatment plan. Middle ear endoscopy gives hard-evidence diagnosis and basis for an individual treatment plan. Methods and material: Prospective clinical follow-up study for a cohort of generally healthy elementary school age children with unilateral conductive HL with unknown etiology. The study population was 192 children, of which 46 had a HL of at least 25 dB with more than 10 dB conductive component. Mean age was 8.7 years. Preoperative tests included otomicroscopy, bone- and air-conduction audiogram, tympanometry, stapes reflex tests, Rinne and Weber test and Otoacoustic emissions. The children underwent endoscopy of the middle ear with an individual treatment plan and long-term follow-up. The aim was to explore etiology and to give a treatment plan for hearing loss. Follow-up included air- and bone conduction hearing tests annually or every other year. Mean follow-up was 5.2 years. Results: A clear etiological finding was found in 36 (78%) ears, stapes anomaly (23) as the most common (64%) finding. Other findings were two cholesteatomas, 2 status after trauma, 5 middle ear anomalies, 5 incus fixations and one incus erosion. Air conduction hearing improved spontaneously during follow-up in 81% (17/21, 2 dropouts) of the stapes anomaly ears (mean 11,3 dB, range 4-32 dB), and none of these ears showed hearing deterioration. In the incus fixation group, one ear showed hearing deterioration. There were no major complications for exploration, and 5 minor postoperative infections. Conclusions: The most common reason for pediatric unilateral conductive hearing loss was stapes anomaly/ fixation. The HL does not deteriorate. Hearing loss in stapes anomalies shows a tendency for spontaneous recovery. Stapes surgery can be postponed or avoided.
Subject: Conductive hearing loss
3123 Gynaecology and paediatrics
3125 Otorhinolaryngology, ophthalmology
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: publishedVersion

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