Department of Pediatrics, State University of New York Downstate Medical Center, Brooklyn, New York, United States of America.
PLoS One. 2019 Feb 22;14(2):e0212777. doi: 10.1371/journal.pone.0212777. eCollection 2019.
This study aims to assess prospectively whether there is an association between frequencies of upper respiratory tract infections (URTI) or asthma in early childhood and failed otoacoustic emission (OAE) screenings later in life. There are no clear recommendations for hearing testing following acute otitis media (AOM) infection. This is a retrospective, practice based chart review. Participants from a primary care setting were 517 pre-adolescent and adolescent children (49.9% female) (ages 10-21; mean, 15 y/o), who had presented with at least one specific bacterial URTI (AOM, Group A Streptococcus (GAS) tonsillitis, or Influenza) during childhood. Hearing testing was recorded incidentally at all subsequent routine health care maintenance visits (OAE hearing screen). Simple linear regression analyses were performed using R (v3.4.4). We found that number of episodes of AOM infections strongly correlated with number of failed OAE screenings later in life (F = 76.37; P = <0.001; R2 = 0.1279), while GAS (F = 1.859; P = 0.1733; R2 = 0.0016) or Influenza infection (F = 2.624; P = 0.1059; R2 = 0.0031) were not associated with failed OAE screening. Correlation between number of AOM infections and number of failed OAE screenings was not strengthened by presence of asthma. This study found evidence of an association between childhood history of AOM and failed OAE screenings in adolescence. Since this population may be at a higher risk for developing permanent or fluctuating hearing losses, further studies to clarify indications and timing of standard audiological testing among these children should be considered.
本研究旨在前瞻性评估儿童早期上呼吸道感染(URTI)或哮喘的频率与日后未通过耳声发射(OAE)筛查之间是否存在关联。急性中耳炎(AOM)感染后,对于听力测试尚无明确的建议。这是一项回顾性的基于实践的图表回顾研究。来自初级保健机构的参与者是 517 名青春期前和青少年儿童(49.9%为女性)(年龄 10-21 岁;平均年龄 15 岁),他们在儿童时期至少出现过一次特定的细菌性 URTI(AOM、A 组链球菌(GAS)扁桃体炎或流感)。在所有随后的常规健康保健就诊时(OAE 听力筛查)都会偶然进行听力测试。使用 R(v3.4.4)进行简单线性回归分析。我们发现,AOM 感染次数与日后未通过 OAE 筛查的次数密切相关(F = 76.37;P <0.001;R2 = 0.1279),而 GAS(F = 1.859;P = 0.1733;R2 = 0.0016)或流感感染(F = 2.624;P = 0.1059;R2 = 0.0031)与未通过 OAE 筛查无关。AOM 感染次数与 OAE 筛查失败次数之间的相关性不因哮喘的存在而增强。本研究发现儿童时期 AOM 病史与青春期 OAE 筛查失败之间存在关联。由于该人群可能面临更高的永久性或波动性听力损失风险,因此应进一步研究以明确这些儿童进行标准听力测试的指征和时机。