Comparative analysis between effective gain and functional gain in bone-anchored hearing aid users

Abstract The cases of ear malformations, conductive, mixed, and single-sided deafness hearing loss are candidates for surgery and use of Bone-Anchored Hearing Aids (BAHA). Commonly, the literature highlights two procedures to assess the benefits and characteristics of amplification in users: functional gain (FG) and effective gain (EG). Objective Estimate and compare the EG and the FG to evaluate the benefits obtained by users of BAHA and, later, to compare tests of speech perception in silence and in noise. Methodology The sample (n=79) was divided into four groups, implanted from February 2014 to February 2021. The following tests were analyzed: pure-tone audiometry by air and bone; research of audiometric thresholds in free field; speech perception tests in silence and in noise. Results EG presented lower values than FG in all frequencies. The positive results of the speech perception tests were correlated with worse FG values. EG is the best method for evaluation, as it allows a proper comparison between devices, as well as a comparison with the prescription of validated rules. Conclusions A better evaluation of results was observed on the EG values, indicating that it is a relevant method to assess auditory performance. In addition, the FG results were incompatible with the benefits obtained in the speech perception tests, showing that it is not a reliable tool for monitoring the results with the use of BAHA.

Simultaneous operations of vibrant soundbridge implantation and auricular reconstruction for patients with microtia and atresia / 中华整形外科杂志

Objective@#To discuss the safety and efficacy of simultaneous procedures of vibrant soundbridge implantation and auricular reconstruction with congenital external and middle ear malformation.@*Methods@#This is a retrospective study, including 6 patients, 5 boys and 1 girl, aged 7-12 years. All patients received simultaneous operations of vibrant soundbridge implantation and auricular reconstruction. The mean preoperative air conduction threshold was 64.8 dB HL at 0.5, 1, 2, and 4 kHz. The VSB was placed in the third stage of auricle reconstruction, if the soft tissue expansion was performed; otherwise, the VSB was implanted in the second stage. The satisfaction with reconstructed auricle, surgical complications, hearing improvement and speech discrimination scores were evaluated 6 months after surgery.@*Results@#All patients and their families reported satisfaction with their reconstructed auricle. There was no complications, including cartilage framework exposion, infection, hematoma, skin flap necrosis, facial paralysis, tinnitus, vertigo or others. Post-operatively, mean VSB-aided hearing threshold was 36.7 dB HL, which was reduced by 28.1 dB HL. The mean speech discrimination scores measured in a sound field with a presentation level of 65 dB SPL and 80 dB SPL were improved.@*Conclusions@#The simultaneous operations of auricle reconstruction and Vibrant Soundbridge implantation is an alternative method for patients with congenital microtia and atresia.

Safety and Effectiveness of Endoscopic Ear Surgery: Systematic Review / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: This study aims to evaluate that usefulness of the endoscopic ear surgery (EES) through the systematic review. SUBJECTS AND METHOD: We searched literatures in literature databases (MEDLINE, EMBASE, Cochrane Library, etc.). Inclusion criteria is 1) studies of patients with chronic otitis media, otitis media with effusion, cholesteatoma, conductive hearing loss, mixed hearing loss etc. 2) studies in which a transcanal endoscopic surgery was performed; and 3) studies in which one or more of the appropriate medical outcomes have been reported. We excluded that 1) non-human studies and pre-clinical studies; 2) non-original articles, for example, non-systematic reviews; editorial, letter and opinion pieces; 3) research not published in Korean and English; and 4) grey literature. Finally, 65 articles were selected and those results were analyzed. RESULTS: The safety of the EES was reported in 61 articles. Some studies reported damaged facial nerve or perilymph gusher but these are the complications that can arise due to the characteristics of the disease and not due to the EES and other reported complications were of similar or lower level in the intervention group rather than the microscopy group. The effectiveness of the EES was reported in 23 articles. The EES tended to show improved effects in terms of graft uptake status, cholesteatoma removal, and hearing improvement although effective outcomes of most studies reported no significant difference between EES and microscopic ear surgery. CONCLUSION: EES is a safe and effective technique and as it is less invasive than the microscopic ear surgery.

Contralateral Occlusion Test (COT): the effect of external ear canal occlusion with aging / Teste de Oclusão Contralateral (TOC): o efeito da oclusão do canal auditivo externo com a idade

ABSTRACT Purpose This study aimed to evaluate the effects of complete external ear canal occlusion on hearing thresholds with aging. The goal was to decide which tuning fork is more appropriate to use for the contralateral occlusion test (COT), in individuals of different ages. Methods Forty-two normal hearing subjects between 21 and 67 years were divided into three age groups (20-30 years, 40-50 years, and 60-70 years). Participants underwent sound field audiometry tests with warble tones, with and without ear canal occlusion. Each ear was tested with the standard frequencies (250, 500, 1000, and 2000 Hz). The contralateral ear was suppressed by masking. Results Hearing thresholds showed an increase as the frequency increased from 20.85 dB (250 Hz, 20-30 years group) to 48 dB (2000 Hz, 60-70 years group). The threshold differences between occlusion and no occlusion conditions were statistically significant and increased ranging from 11.1 dB (250 Hz, 20-30 years group) to 32 dB (2000 Hz, 20-30 years group). We found statistically significant differences for the three age groups and for all evaluations except to 500 Hz difference and average difference. The mean hearing loss produced by occlusion at 500 Hz was approximately 19 dB. We found no statistically significant differences between right and left ears and gender for all measurements. Conclusion We conclude that the use of the 512 Hz tuning fork is the most suitable for COT, and its use may allow clinicians to distinguish mild from moderate unilateral conductive hearing loss.

RESUMO Objetivo O objetivo deste estudo foi avaliar o efeito da oclusão completa do canal auditivo externo nos limiares auditivos, em indivíduos de idades distintas, para apurar qual o diapasão mais adequado na realização do teste de oclusão contralateral (TOC). Método 42 indivíduos normo-ouvintes (21-67 anos) foram divididos em três grupos etários (20-30, 40-50 e 60-70 anos). Os participantes foram avaliados com testes de audiometria tonal liminar em campo livre, com e sem oclusão completa do canal auditivo externo. Cada ouvido foi testado para as frequências 250, 500, 1000 e 2000 Hz. No ouvido contralateral, foi realizado mascaramento, para evitar a ocorrência de audição contralateral. Resultados Verificou-se aumento dos limiares auditivos, diretamente proporcional ao aumento da frequência (desde 20.85 até 48 dB). A diferença nos limiares auditivos entre a condição de oclusão e de não oclusão foi estatisticamente significativa em todas as frequências e aumentou de forma diretamente proporcional com a frequência (desde 11.1 até 32 dB). Foram também encontradas diferenças estatisticamente significativas para os três grupos etários, em todos os parâmetros, exceto na diferença a 500 Hz e na diferença total média. A perda auditiva média resultante da oclusão aos 500 Hz foi de 19 dB. Não se encontraram diferenças estatisticamente significativas entre o ouvido direito e o esquerdo, e entre o gênero. Conclusão A utilização do diapasão de 512 Hz é a mais adequada para o TOC. A sua utilização pode permitir aos clínicos, em ambiente de consulta e de forma rápida, a distinção entre perda condutiva de grau leve a moderada.

Estudio Transversal: Hipoacusia Laboral Inducida por Ruido en Personal de Aeronáutica del Ejército Ecuatoriano y Factores Asociados. Quito ­ Ecuador, 2014 - 2016 / Cross-sectional research: Noise-induced Occupational Hypoacusis in Aeronautical Personnel of the Ecuadorian Army and Associated Factors. Quito - Ecuador, 2014 - 2016

INTRODUCCIÓN: La hipoacusia laboral inducida por ruido es una patología ocupacional frecuente, responsable de pérdidas de la audición sino se controla a tiempo. El objetivo del estudio fue establecer la prevalencia de hipoacusia laboral inducida por ruido y factores relacionados en el personal de aeronáutica del ejército. MÉTODOS: Estudio transversal analítico en el personal tripulación del ejército ecuatoriano, Quito ­ Ecuador, período 2014 ­ 2016 que relacionó asociación causal entre hipoacusia laboral inducida por ruido con variables como edad, función, rango, antecedentes de hipoacusia en el servicio militar. Se trabajó con todo el personal de vuelo, 112 militares en servicio activo. RESULTADOS: El promedio de edad fue de 37 años. Todos eran varones. El 55.4 % pertenecía a tropa y 44. 6 % eran oficiales. El 44.6 % eran pilotos; 28.6 % mecánicos y 26.8 % ingenieros de vuelo. La prevalencia de hipoacusia general fue del 35.6 %; la de hipoacusia unilateral fue del 19.6 % y de la bilateral del 16 %. La frecuencia de antecedentes de hipoacusia laboral asociada a ruido en la aeronáutica fue del 60.7 %. La prevalencia de hipoacusia leve fue del 17.8 %; moderada con 6.7 % y severa con 1.35 %. Las variables asociadas a hipoacusia laboral inducida por ruido en el personal militar en funciones de vuelo fueron: la edad, el rango, la función y antecedentes de hipoacusia. El oído izquierdo suele afectarse más que el derecho. La hipoacusia bilateral más frecuente fue la leve derecha con agudeza normal izquierda (10.7 %). CONCLUSIONES: La hipoacusia laboral inducida por ruido es multifactorial y puede ser reversible si se detiene el causal o si se llevan a cabo medidas de protección adecuadas. El nivel de hipoacusia en el personal militar de vuelo tiene asociación con: la edad, el rango, la función y los antecedentes de hipoacusia laboral en funciones de vuelo.

BACKGROUND: Hearing loss is induced by noise in job and is a frequent illness, responsible of hearing loss if it is not controlled on time. The aim of this study is establish the prevalence of hearing loss and related factors in army aviation personnel. METHODS: An analytical cross - sectional study of the Ecuadorian army crew, Quito - Ecuador, between 2014 and 2016, which related a causal association between hearing loss induced by noise in job with variables such as age, function, rank and backgrounds of hearing loss in military service. It worked with all the personnel of flight 112 military in active service. RESULTS: The mean age was 37 years. All were male. 55.4% belonged to troops and 44. 6 % were officers. 44.6 % were pilots; 28.6 % were mechanics and 26.8 % were flight engineers. The prevalence of general hearing loss was 35.6 %. The prevalence of unilateral hearing loss was 19.6 % and bilateral prevalence was 16 %. The frequency of antecedents of occupational hearing loss associated with aviation noise in this staff was of 60.7 %. The prevalence of mild hearing loss was 17.85 %; moderate hearing loss 6.7 % and severe of 1.35 %, no profound hearing loss was reported. The variables associated with decreased auditory acuity are: age, aviation exercise time, range, function, and history of hearing loss within the aeronautical field. Bilateral damage has a statistical tendency with age and association with the range. No deep hearing loss was found. CONCLUSION: Noise-induced occupational hearing loss is multifactorial and may be reversible if the cause is stopped or appropriate protective measures are taken. The level of hearing loss in military flight personnel has an association with: age, range, function, and history of occupational hearing loss in flight functions.

Surgical and Audiologic Comparison Between Sophono and Bone-Anchored Hearing Aids Implantation

OBJECTIVES: Bone-anchored hearing aids (BAHA) occasionally cause soft tissue problems due to abutment. Because Sophono does not have abutment penetrating skin, it is thought that Sophono has no soft tissue problem relating to abutment. On the other hand, transcutaneous device's output is reported to be 10 to 15 dB lower than percutaneous device. Therefore, in this study, Sophono and BAHA were compared to each other from surgical and audiological points of view. METHODS: We retrospectively reviewed the medical records of 9 Sophono patients and 10 BAHA patients. In BAHA cases, single vertical incision without skin thinning technique was done. We compared Sophono to BAHA by operation time, wound healing time, postoperative complications, postoperative hearing gain after switch on, and postoperative air-bone gap. RESULTS: The mean operation time was 60 minutes for Sophono and 25 minutes for BAHA. The wound healing time was 14 days for Sophono and 28 days for BAHA. No major intraoperative complication was observed. Skin problem was not observed in the 2 devices for the follow-up period. Postoperative hearing gain of bilateral aural atresia patients was 39.4 dB for BAHA (n=4) and 25.5 dB for Sophono (n=5). However, the difference was not statistically significant. In all patients included in this study, the difference of air-bone gap between two groups was 16.6 dB at 0.5 kHz and 18.2 dB at 4 kHz. BAHA was statistically significantly better than Sophono. CONCLUSION: Considering the audiologic outcome, BAHA users were thought to have more audiologic benefit than Sophono users. However, Sophono had advantages over BAHA with abutment in cosmetic outcome. Sophono needed no daily skin maintenance and soft tissue complication due to abutment would not happen in Sophono. Therefore, a full explanation about each device is necessary before deciding implantation.

Methodology for Intraoperative Laser Doppler Vibrometry Measurements of Ossicular Chain Reconstruction

OBJECTIVES: Despite the increasing number of research concerning the applications of the Laser Doppler Vibrometry (LDV) in medicine, its usefulness is still under discussion. The aim of this study is to present a methodology developed in our Department for the LDV intraoperative assessment of ossicular chain reconstruction. METHODS: Ten patients who underwent "second look" tympanoplasty were involved in the study. The measurements of the acoustic conductivity of the middle ear were performed using the LDV system. Tone bursts with carrier frequencies of 500, 1,000, 2,000, and 4,000 Hz set in motion the ossicular chain. The study was divided into four experiments that examined the intra- and interindividual reproducibility, the utility of the posterior tympanotomy, the impact of changes in the laser beam angle, and the influence of reflective tape presence on measurements. RESULTS: There were no statistically significant differences between the two measurements performed in the same patient. However, interindividual differences were significant. In all cases, posterior tympanotomy proved to be useful for LDV measurements of the ossicular prosthesis vibrations. In most cases, changing the laser beam angle decreased signal amplitude about 1.5% (not significant change). The reflective tape was necessary to achieve adequate reflection of the laser beam. CONCLUSION: LDV showed to be a valuable noncontact intraoperative tool for measurements of the middle ear conductive system mobility with a very good intraindividual repeatability. Neither a small change in the angle of the laser beam nor performing the measurements through posterior tympanotomy showed a significant influence on the results. Reflective tape was necessary to obtain good quality responses in LDV measurements.

Vestibulotomy in Congenital Stapes Fixation with Anomalous Facial Nerve / 대한이비인후과학회지

Conductive hearing loss is a condition that can be corrected surgically in most cases. Stapedotomy is usually performed for patients with congenital ossicular anomaly or fixation. However, otologic surgeons have often encountered difficulty due to the complexity of stapes surgery. Moreover, congenital stapes fixation with anomalous facial nerve and oval window absence is an uncommon and dangerous condition. In such cases, vestibulotomy can be a surgical option to prevent facial nerve damage and improve hearing. The etiology can be explained by the embryological development of the middle ear structures. To prevent facial nerve damage and maximize the efficacy of surgery, the surgeon should have knowledge about this disease and take a computed tomography for double check before stapes surgery. We describe a case of congenital stapes fixation with aberrant facial nerve courses, a 15-year-old female who was treated with vestibulotomy and piston wire insertion.

Medidas de imitância acústica de banda larga com estímulo chirp e tom puro em lactentes com normalidade de orelha média / Wideband acoustic immittance measures using chirp and pure tone stimuli in infants with middle ear integrity

RESUMO Objetivo: Caracterizar os valores de reflectância e absorvância de banda larga em lactentes com integridade de orelha média. Métodos: Foram analisados os valores de reflectância e absorvância de banda larga, para os estímulos chirp e tom puro, de 31 orelhas de 18 lactentes, na faixa etária de 10 dias a cinco meses de idade. Considerou-se como critérios de inclusão: ausência de fator de risco para deficiência auditiva, timpanometria com sonda de 1000 Hz, sugerindo normalidade de orelha média e presença de emissões otoacústicas evocadas por estímulo transiente, na triagem auditiva neonatal. Resultados: Os valores de reflectância mostraram-se maiores para as baixas frequências, reduzindo para as médias e aumentando, novamente, para as frequências altas, enquanto para os valores de absorvância, o comportamento foi o oposto. Não existiu diferença significativa entre os estímulos chirp e tom puro. Conclusão: Observou-se um comportamento típico das medidas estudadas, caracterizado por maior reflectância nas frequências graves e maior absorvância para as frequências médias.

ABSTRACT Purpose: To characterize the wideband reflectance and absorbance values in infants with middle ear integrity. Methods: The wideband reflectance and absorbance values for chirp and pure tone stimuli of 31 ears of infants aged 10 days to five months were analyzed. Inclusion criteria considered: 1000 Hz tympanometry. suggesting normal middle ear and the presence of transient evoked otoacoustic emission. Results: The reflectance values were shown to be greater for low frequencies, reducing to medium ones and increasing once again to high frequencies, while the absorbance values displayed an opposite behavior. No significant difference was verified between chirp and pure tone stimuli. Conclusion: A typical behavior of the measures, characterized by a higher reflectance at low frequencies and higher absorbance at medium frequencies was observed in the population studied.

Results of the implantation of bone-anchored hearing aids in patients with treacher-collins syndrome

INTRODUCTION: Treacher-Collins syndrome is characterized by craniofacial malformations, narrowing of the external auditory canal (EAC), and, in 30% of cases, agenesis of the canal and ossicular chain defects. The use of hearing aids (HA) is not possible in cases in which agenesis or stenosis of the EAC accompanies conductive deafness. In contrast, bone conduction implants such as the Bone Anchored Hearing Aid (BAHA®) allow direct stimulation of the cochlea and are thus superior to conventional hearing aids in cases of severe conductive hearing loss. OBJECTIVE: To present 2 cases of patients with Treacher-Collins syndrome who underwent implantation of BAHA®. CASES REPORTS: The first patient was a 52-year-old woman diagnosed with Treacher-Collins syndrome who presented with severe bilateral mixed hearing loss and a history of unsuccessful previous use of a bone contact conduction device. The BAHA® implantation was uneventful, and the post-operative results were good. The second patient was a 14-year-old girl who was also diagnosed with Treacher-Collins Syndrome with bilateral moderate conductive hearing loss by audiometry. The use of a bone vibrator contact device did not improve her hearing; however, implantation of a BAHA® resulted in a decreased gap postoperatively. FINAL COMMENTS: BAHA® hearing devices provide adequate rehabilitation and consequent improvement of the quality of life in patients with Treacher-Collins syndrome.

Perda auditiva sensorioneural em pacientes com acromegalia em tratamento / Sensorineural hearing loss in acromegalic patients under treatment

Acromegalia é uma doença endócrina rara. Poucos estudos avaliaram sua associação com deficiência auditiva (DA) e os resultados são conflitantes. OBJETIVOS: Avaliar a prevalência e características da DA em um grupo de pacientes com acromegalia em tratamento. Analisar a transmissão auditiva central e periférica. MATERIAL E MÉTODOS: Estudo transversal. Um grupo de 34 pacientes com acromegalia submeteu-se à avaliação metabólica, audiometria tonal e potenciais evocados auditivos de tronco encefálico (PEATE). Considerou-se DA quando a média dos tons puros foi > 25 DBNA para baixas frequências (250, 500, 1000 e 2000 Hz) ou altas frequências (3000, 4000, 6000 e 8000 Hz). Os pacientes foram divididos em grupo A (com DA) e B (sem DA). RESULTADOS: Doze pacientes (35,3%) mostraram DA sensorioneural (grupo A), sendo oito bilateral e quatro unilateral. Nenhum apresentou DA mista ou condutiva. A prevalência de diabetes/intolerância à glicose de jejum foi similar entre os grupos. As frequências de 3000, 4000, 6000 e 8000 Hz foram as mais afetadas e com padrão similar em ambos os lados. CONCLUSÃO: DA sensorioneural esteve presente em 35,3% dos casos. Não foram notadas diferenças clínicas ou metabólicas significativas entre os grupos, bem como na transmissão neural auditiva periférica e central.

Acromegaly is a rare endocrine disease. Few studies have evaluated its association with hearing loss (HL) and the results are conflicting. AIM: To evaluate the prevalence and features of HL in a group of patients being treated for acromegaly. To analyze peripheral and central auditory transmission. METHODS: Cross-sectional study. A group of 34 patients with acromegaly were submitted to metabolic evaluation, tonal audiometry and brainstem auditory evoked potentials. HL was considered when pure tone average was > 25 DBHL for low frequencies (250, 500, 1000 and 2000 Hz) or high frequencies (3000, 4000, 6000 and 8000 Hz). The patients were divided in group A (with HL) and B (without HL). RESULTS: Twelve patients (35.3%) had sensorineural HL (Group A), being 8 bilateral and 4 unilateral. No one had mixed or conductive HL. The prevalence of diabetes/impaired glucose tolerance was similar between the groups. The frequencies 3000, 4000, 6000 and 8000 Hz were the most affected and with a similar pattern in both ears. CONCLUSION: sensorineural HL was found in 38.9% of cases. Neither clinical nor metabolic differences were noted between the groups, as well as in regards to peripheral and central auditory transmission.

Influência do tipo de transdutor no mascaramento em deficiência auditiva condutiva e mista bilateral / Influence of transducer's type in bilateral conductive and mixed hearing loss masking

OBJETIVO: verificar a influência do tipo de transdutor na quantidade de mascaramento necessária para obtenção de limiares por vias aérea e óssea em indivíduos com deficiência auditiva condutiva e mista. MÉTODO: foram avaliados 16 indivíduos com presença de deficiência auditiva condutiva ou mista bilateral simétrica com gap aéreo-ósseo de no mínimo 15dBNA. Os indivíduos foram submetidos à anamnese, meatoscopia, medidas de imitância acústica, audiometria tonal liminar e audiometria vocal, realizadas com fones supra-aurais TDH-39 e com os fones de inserção ER-3A. RESULTADOS: não houve diferença estatisticamente significante entre as orelhas independentemente do tipo de transdutor. A quantidade de mascaramento utilizada com o fone de inserção ER-3A para testar a via aérea, nas frequências de 250Hz e 500Hz, foi menor do que a utilizada com o fone supra-aural, com significância estatística. CONCLUSÕES: há influência do tipo de transdutor na quantidade de mascaramento utilizada para obtenção dos limiares de via aérea e via óssea, principalmente nas frequências baixas, sendo que a quantidade de mascaramento com o fone de inserção é menor tanto para testar a via aérea como a via óssea.

PURPOSE: this study aimed at examining the influence of transducer's type in the amount of masking needed to obtain air and bone conducted thresholds in subjects with conductive and mixed hearing losses. METHOD: 16 patients with symmetric bilateral conductive hearing deficiency or mixed hearing loss with air-bone gap of at least 15dBNA were examined. The subjects underwent clinical history, otoscopy and acoustic immittance measures (tympanometry and acoustic reflex), and subsequently, pure tone and speech audiometry (SRT and WRS). Pure tone threshold and speech audiometry were performed both with supra-aural TDH-39 and insertion earphones ER-3A. RESULTS: there was no statistically significant difference between the ears regardless of the type of transducer. The amount of masking used with the insertion earphone ER-3A in order to test the air thresholds, in the frequencies of 250Hz and 500Hz, was lower than the one used with supra-aural headset with statistical significance. CONCLUSIONS: transducer's type influences in the amount of masking used in order to obtain air and bone conducted thresholds, mainly in the low frequencies, whereas the amount of masking with the insertion phone is smaller, both for testing the air as well as the bone thresholds.

Otite média recorrente e habilidade de localização sonora em pré-escolares / Otitis media and sound localization ability in preschool children

OBJETIVO: comparar o desempenho de 40 pré-escolares no teste de localização sonora com as respostas de seus pais para um questionário que investigou a ocorrência de episódios de otite média (OM) e os sintomas indicativos de desordens audiológicas e do processamento auditivo. MÉTODOS: após aplicação e análise das respostas do questionário, dois grupos foram formados: GO, com histórico de OM, e GC, sem este histórico. Cada grupo com 20 pré-escolares de ambos os gêneros foi submetido ao teste de localização da fonte sonora em cinco direções (Pereira, 1993). RESULTADOS: a comparação entre GO e GC não mostrou diferença estatisticamente significante (p=1,0000). CONCLUSÃO: as otites recorrentes na primeira infância não influenciaram no desempenho da habilidade de localização sonora dos pré-escolares deste estudo. Embora sejam dois instrumentos baratos e de fácil aplicação, o questionário e o teste de localização não foram suficientes para diferenciar os dois grupos testados.

PURPOSE: to compare the sound localization ability of 40 preschool children with their parents' answers. The questionnaire answered by the parents investigated otitis media (OM) episodes and symptoms that indicated the audiological and auditory processing disabilities. METHODS: after applying and analyzing the questionnaire's answers, two groups were formed: OG (with OM) and CG (control group). Each group with 20 preschool children, of both genders, was submitted to the sound localization test in five directions (according to Pereira, 1993). RESULTS: comparison between OG and CG did not reveal statistically significant difference (p=1.0000). CONCLUSION: OM episodes during first infancy did not influence the sound localization ability in this preschool children study. Although both used evaluation instruments (questionnaire and sound localization test) are cheap and easy to apply they are not sufficient to differ both tested groups.

Conductive Hearing Loss with Intact Tympanic Membrane: Two Cases of Fibrous Change of the Ossicles / 대한이비인후과학회지

In general, causes of conductive hearing loss with the intact tympanic membrane and external auditory canal are known as congenital anomaly of the ossicular chain, otosclerosis, and head trauma-induced ossicular discontinuity. But it may also occur due to fibrotic change by potential inflammation of the ossicular chain as a result of otitis media in the infancy or childhood. We report two cases of fibrous change of the ossicles by probable middle ear inflammation with a review of the related literature.