Does nose blowing improve hearing in serous otitis? A community study.

Otitis media with serous effusion (glue ear) is one of the most common problems seen by family doctors. In order to evaluate the effect of regular nose blowing on the resolution of serous otitis a randomized trial was carried out in a community health audiology department in Oxfordshire over the period 1983-87. A total of 84 children aged three and a half to four and a half years, found to have a conductive hearing loss owing to serous otitis were included in the study. The hearing test combined a discrimination test of seven named toys and full audiometry with earphones. The children's ears were examined by otoscope and Rinne's tuning fork test was performed. Randomly selected children were advised to blow their noses or were given no advice. The children were retested two months later and the outcome determined for children who were or were not given advice and who were or were not naturally good nose blowers. A record was made of any surgical intervention by insertion of ventilating tubes carried out before the children started school and of the results of the children's routine hearing tests on school entry. No significant differences in the proportion of children passing the second hearing test were found between children advised to blow their noses and those given no advice or between those children who were naturally good at nose blowing and those who were not. Neither was there any association between the proportion of children passing the school audiometry test and nose blowing advice being given, nose blowing ability or surgical intervention.(ABSTRACT TRUNCATED AT 250 WORDS)

Occurrence of childhood cancers among sibs and estimation of familial risks.

An analysis which includes the majority of the cases of childhood cancer occurring in Britain over a period of about 20 years suggests that there is a small familial element in the aetiology of these diseases; aggregations within sibships were observed more frequently than would be expected by chance. Possible explanations of these findings are considered. Some, perhaps many, of the cases within such sibships may be due to associations between malignant disease and various genetically determined conditions at a suclinical level or in the heterozygous state. Alternatively, the observed familial aggregations may be attributable to the fact that sibs share a common environment. Childhood cancer in twins is discussed and findings compared with those from the United States. Attention is drawn to a number of interesting combinations of tumours in sibs, particularly brain tumours and bone cancers. The implications of the findings for genetic counselling are discussed; it is emphasized that, though there appears to be an increased risk that sibs of children with malignant disease will also be affected by such diseases, this amounts overall only to a doubling of the general population risk. Whether or not the explanation is a genetic one, the actual magnitude of the risk for such sibs is only about 1 in 300.