Alenezi Eman M A, Robinson Monique, Choi Robyn S M, Veselinović Tamara, Richmond Peter C, Eikelboom Robert H, Brennan-Jones Christopher G
Faculty of Allied Health Sciences, Kuwait University, Kuwait; The University of Western Australia, Perth, Western Australia, Australia; Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
Int J Pediatr Otorhinolaryngol. 2022 Dec;163:111379. doi: 10.1016/j.ijporl.2022.111379. Epub 2022 Nov 9.
To investigate the long-term impact of recurrent otitis media (rOM) and ventilation tube insertion (VTI) in early childhood on hearing outcomes and middle-ear health three to five years later, in a prospective pregnancy cohort study.
Children were classified into rOM (n = 314), VTI (n = 94), and reference (n = 1735) groups, according to their otitis media (OM) history in their first three years of life. Audiometry at frequencies 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz, and tympanometry were performed when children were approximately six years of age.
A binary logistic regression incorporating a range of potential confounding variables showed that hearing outcomes and middle-ear health status in children who had early childhood rOM with or without undergoing VTI were not significantly different to those in the reference group. The only significant difference was found in the VTI group for both tympanometry (OR = 2.190; 95% CI = 1.123, 4.270) and audiometry outcomes at 4000 Hz (OR = 3.202; 95% CI 1.341, 6.717), in the left ear only. The median score of the better ear 4FA was 20 dB in children in all groups.
Children with rOM with or without undergoing VTI in the first three years of childhood had comparable hearing outcomes and middle-ear health status to those with no history of the disease, at around the age of six years. Although children who underwent VTI had an increased risk of abnormal middle-ear status and some elevation in hearing levels in their left ear only, their audiometry results were still within normal limits, indicating that the impact of VTI in early childhood is unlikely to have clinically significant adverse impact on later hearing outcomes.
在前瞻性妊娠队列研究中，调查儿童期复发性中耳炎（rOM）和置管术（VTI）对三至五年后听力结果和中耳健康的长期影响。
根据儿童生命最初三年的中耳炎（OM）病史，将其分为rOM组（n = 314）、VTI组（n = 94）和参照组（n = 1735）。当儿童约六岁时，进行500Hz、1000Hz、2000Hz和4000Hz频率的听力测定以及鼓室图检查。
纳入一系列潜在混杂变量的二元逻辑回归显示，患或未患rOM且接受或未接受VTI的儿童的听力结果和中耳健康状况与参照组儿童无显著差异。仅在VTI组中发现，仅左耳的鼓室图检查（比值比[OR]=2.190；95%置信区间[CI]=1.123，4.270）和4000Hz听力测定结果（OR = 3.202；95%CI 1.341，6.717）存在显著差异。所有组儿童较好耳4FA的中位数分数均为20dB。
在儿童期前三年患或未患rOM且接受或未接受VTI的儿童，在六岁左右时，其听力结果和中耳健康状况与无该病病史的儿童相当。虽然接受VTI的儿童中耳状态异常风险增加且仅左耳听力水平有所升高，但其听力测定结果仍在正常范围内，这表明儿童期VTI对后期听力结果不太可能产生具有临床意义的不利影响。
