Al-Rowaily Mohammed A, AlFayez Abdulrhman I, AlJomiey Mohammed S, AlBadr Adil M, Abolfotouh Mostafa A
Family and Community Medicine Department, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh NGHA, Saudi Arabia.
Int J Pediatr Otorhinolaryngol. 2012 Nov;76(11):1674-7. doi: 10.1016/j.ijporl.2012.08.004. Epub 2012 Aug 24.
Hearing loss among school-entrant children in the developing world has been widely reported as a significant health problem. Failure to detect hearing loss, either congenital or acquired, in children may result in lifelong deficits in speech and language acquisition. The aims of this study were: (1) to estimate the prevalence of hearing loss and (2) to identify its different types.
This is a cross-sectional study that included all children (n=2574) aged 4-8 years who attended the obligatory health examination for kindergarten (=370) and primary school (n=2204) entry at the school health center of King Abdulaziz Medical City, Riyadh, Saudi Arabia, from March 2009 to December 2010. Pure-tone air conduction audiometry was conducted for each child in a sound-treated room followed by a diagnostic test. Tympanometry was performed as a complement to the overall objectives of a hearing screening program.
A total of 45 children were diagnosed with hearing impairment (84.4% conductive and 15.6% sensori-neural), with an overall prevalence of 1.75% (95% C.I.: 1.25, 2.25). The majority of cases were females (71.1%), of school age (80.0%), with conductive deafness (84.4%). More than one-half of cases had bilateral deafness (55.6%) of mild degree (57.8%). As for conductive deafness, otitis media with effusion ranked first as a cause of deafness (34.9%), followed by wax and chronic otitis media (23.3% each), while traumatic perforated drum came last (2.3%). Sensorineural deafness constituted 16.2% of all cases.
Conductive hearing loss is the primary type of hearing loss among children and is easy to correct. The urgent development of audiological services in other school health centers in the country, particularly those with good referral systems to Ministry of Health hospitals, is needed. Evidence-based guidelines to identify, monitor, and manage otitis media with effusion (OME) in children in the primary healthcare setting and a strategy to prevent hearing loss are recommended.
发展中国家入学儿童的听力损失已被广泛报道为一个重大的健康问题。未能在儿童中检测出先天性或后天性听力损失可能会导致其在言语和语言习得方面出现终身缺陷。本研究的目的是：（1）估计听力损失的患病率；（2）确定其不同类型。
这是一项横断面研究，纳入了2009年3月至2010年12月期间在沙特阿拉伯利雅得阿卜杜勒阿齐兹国王医疗城学校健康中心参加幼儿园（n = 370）和小学（n = 2204）入学义务健康检查的所有4至8岁儿童（n = 2574）。在隔音室内为每个儿童进行纯音气导听力测定，随后进行诊断测试。进行鼓室导抗图检查以辅助听力筛查计划的总体目标。
共有45名儿童被诊断为听力障碍（84.4%为传导性，15.6%为感音神经性），总体患病率为1.75%（95%置信区间：1.25, 2.25）。大多数病例为女性（71.1%），为学龄儿童（80.0%），患有传导性耳聋（84.4%）。超过一半的病例为双侧耳聋（55.6%），且为轻度（57.8%）。至于传导性耳聋，积液性中耳炎作为耳聋原因位居首位（34.9%），其次是耵聍和慢性中耳炎（各占23.3%），而外伤性鼓膜穿孔排在最后（2.3%）。感音神经性耳聋占所有病例的16.2%。
传导性听力损失是儿童听力损失的主要类型，且易于矫正。该国其他学校健康中心，特别是那些与卫生部医院有良好转诊系统的中心，迫切需要发展听力学服务。建议制定基于证据的指南，以在初级卫生保健环境中识别、监测和管理儿童积液性中耳炎（OME），并制定预防听力损失的策略。
