Department of Otorhinolaryngology - Head and Neck Surgery, Rush University Medical Center, Chicago, IL, 60612, USA.
Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, IL, 60515, USA.
Int J Pediatr Otorhinolaryngol. 2022 Sep;160:111222. doi: 10.1016/j.ijporl.2022.111222. Epub 2022 Jun 25.
Hearing loss disproportionately affects low- and middle-income countries. Children with undiagnosed hearing loss may have difficulty with learning, language development, and behavior. The aim of this study was to understand the extent of hearing loss and common otologic disorders among school-age children in the rural western region of the Dominican Republic and to chronical the early stages of a limited-resource, locally-sustained hearing screening program in tandem with a bi-annual surgical mission.
Hearing screenings were performed for 528 school-age children (1056 ears, age 5-17 years old) over 5 days in a village hospital in Peralta, DR. Testing initially included otoscopy and screening audiometry. Children who referred or could not be conditioned underwent distortion product otoacoustic emissions (OAEs), and tympanometry. Children who referred following both screening audiometry and OAEs were considered to have hearing loss. Those with normal tympanograms were considered potential hearing aid candidates.
Abnormal ear examination/otoscopic results were present in 43 children (8.1%) and included: microtia/atresia, impacted cerumen, ear canal foreign body, serous otitis media, otitis externa, and tympanosclerosis. 55 of 528 school-age children referred following screening audiometry and 7 were unable to condition. Of these 62 children, 56 tolerated OAEs and 20 referred following OAEs (3.8%). Fourteen children had type B or C tympanogram and 6 school-age children who were determined to have chronic otitis media with effusion (COME) underwent myringotomy and pressure equalization tube placement. Ten of 528 children (1.9%) had normal tympanometry and otoscopy, and referred following screening audiometry and OAEs suggesting the patients may be potential hearing aid candidates.
The prevalence of hearing loss in this cohort of children in the rural, western Dominican Republic was high at roughly 4% with roughly 2% of children being potential hearing aid candidates. Nearly 10% of children screened had an abnormal otologic examination; sometimes easily remedied by otolaryngologic intervention. With the support of local leadership, it is feasible to incorporate hearing services into otolaryngology outreach and build locally sustainable programs.
听力损失在中低收入国家的发病率较高。未被诊断出的听力损失的儿童可能在学习、语言发展和行为方面存在困难。本研究的目的是了解多米尼加共和国西部农村地区学龄儿童听力损失的程度和常见耳科疾病，并记录一个资源有限、由当地维持的听力筛查计划与每两年一次的外展手术任务同时进行的早期阶段。
在多米尼加共和国佩尔塔的一家乡村医院，对 528 名 5-17 岁的学龄儿童（1056 只耳朵）进行了为期 5 天的听力筛查。最初的测试包括耳镜检查和听力筛查。转诊或无法适应的儿童进行畸变产物耳声发射（OAE）和鼓室图测试。在通过听力筛查和 OAE 后转诊的儿童被认为有听力损失。那些鼓室图正常的人被认为是潜在的助听器候选者。
43 名儿童（8.1%）的耳部检查/耳镜结果异常，包括小耳/闭锁、耵聍栓塞、耳道异物、浆液性中耳炎、外耳炎和鼓膜硬化。528 名学龄儿童中，55 名在听力筛查后转诊，7 名无法适应。在这 62 名儿童中，56 名儿童耐受 OAE，20 名在 OAE 后转诊（3.8%）。20 名儿童的鼓室图为 B 型或 C 型，14 名儿童被诊断为慢性分泌性中耳炎（OME），行鼓膜切开术和压力均衡管置入术。10 名儿童的鼓室图和耳镜正常，在听力筛查和 OAE 后转诊，表明这些患者可能是潜在的助听器候选者。
在多米尼加共和国西部农村地区的这组儿童中，听力损失的患病率较高，约为 4%，约有 2%的儿童是潜在的助听器候选者。近 10%的接受筛查的儿童有异常的耳科检查；有时通过耳鼻喉科干预很容易纠正。在当地领导层的支持下，将听力服务纳入耳鼻喉科外展并建立由当地维持的项目是可行的。
