Hearing Loss, Prognosis, and Long-Term Impact of Otitis Media with Effusion in Children

儿童渗出性中耳炎的听力损失、预后和长期影响

• 批准号: 10852143
• 负责人: Gabrielle Ryan Merchant
• 金额: $ 47.51万
• 依托单位: FATHER FLANAGAN'S BOYS' HOME
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-05 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10852143
• 关键词: Acoustics; Address; Affect; Age; Audiology; Auditory Threshold; Behavioral; Binaural; Child; Childhood; Clinic; Clinic Visits; Clinical; Clinical Practice Guideline; Clinical Research; Complex; Computer Models; Conductive hearing loss; Data; Development; Diagnosis; Disease; Disparity; Drops; Ear; Environment; Equipoise; Goals; Hearing; Hearing Tests; Impairment; Incidence; Individual Differences; Infection; Knowledge; Length; Measures; Mechanics; Operative Surgical Procedures; Otitis Media with Effusion; Otoscopy; Outcome; Perforation; Population; Process; Prognosis; Proxy; Recommendation; Research; Resolution; Risk; Risk Factors; Speech; Testing; Time; Tube; United States; Variant; Visit; Work; auditory deprivation; auditory processing; behavior test; childhood hearing loss; clinical decision-making; diagnostic tool; effusion; experience; hearing impairment; improved; individual variation; knowledge base; language processing; long-term sequelae; middle ear; normal hearing; prognostic value; sound; speech processing; tool; underserved community

PROJECT SUMMARY/ABSTRACT Otitis media with effusion (OME) is a common childhood condition characterized by a non-purulent effusion in the middle-ear space. OME can cause conductive hearing loss (CHL), but hearing status varies substantially from normal hearing to moderate hearing losses (0-55 dB HL), and episodes of OME can last for variable lengths of time. Clinical equipoise exists as to whether to treat OME (i.e., surgical tube placement) or wait for it to resolve spontaneously. While there are risks associated with surgery in young children, waiting for OME to resolve spontaneously may also carry risks. OME has been associated with long-term deficits in speech, language, and auditory processing. However, findings from clinical studies are variable, resulting in a persistent debate regarding the long-term sequelae of OME. We hypothesize that a key risk factor for long-term deficits is the cumulative auditory deprivation associated with OME-related CHL, not by the presence of OME itself. If this is the case, only a subset of children with OME (those with notable hearing losses) would be at risk of long-term deficits. As such, it is critical that we determine the hearing status of all children with OME as well as understand the variability in the effects of this hearing loss on long-term outcomes as a function of the degree and symmetry of the loss. While current diagnostic tools can often indicate the presence or absence of OME, there are significant limitations in our ability to determine the presence, degree, and symmetry of the CHL associated with OME due to the challenges with behavioral audiological testing in young children, and no objective alternative to behavioral testing currently exists. Further, even in cases where hearing status can be determined behaviorally, determination of hearing at one time point does not indicate the stability of hearing thresholds or the risk and magnitude of long-term deficits. Our long-term goal is to address these knowledge gaps comprehensively to refine clinical practice guidelines by identifying children most at risk for long-term deficits to improve treatment recommendations. As a first step, the primary objective of this proposal is to improve the diagnosis and understanding of OME and its related hearing loss and investigate the influence of variability in cumulative auditory deprivation on one sequela of OME, binaural processing. In Aim 1, we will develop a non-invasive objective estimate of hearing loss due to OME. In Aim 2, we will characterize the short-term stability and persistence of OME and its related hearing loss and determine the prognostic value of a non-invasive measure of middle-ear mechanics. In Aim 3, we will determine the influence of OME-related variations in CHL and middle- ear mechanics on individual differences in binaural processing. Completion of these Aims will achieve a first step toward our long-term goal of understanding the consequences of OME and developing tools to identify children most at risk for negative sequelae by both improving our ability to objectively determine prognosis and hearing status over time and improving our understanding of how these factors contribute to individual variability in long- term outcomes.

项目摘要/摘要 带积液（OME）的中耳炎是一种常见的童年状况，其特征是非纯种 在中耳空间中。 OME可能会导致导电性听力损失（CHL），但听力状态有很大变化 从正常的听力到中度听力损失（0-55 dB HL），并且OME发作可以持续到可变长度 时间。是否存在临床平衡，以治疗OME（即手术管放置）还是等待它解决 自发。虽然幼儿有手术的风险，但等待OME解决 自发的可能也有风险。 OME与语音，语言和语言的长期赤字有关 听觉处理。但是，临床研究的发现是可变的，导致持续的争论 关于ome的长期后遗症。我们假设长期赤字的关键风险因素是 与OME相关的CHL相关的累积听觉剥夺，而不是由于OME本身的存在。如果是 案例，只有一部分OME（听力损失显着）的儿童将有长期的风险 缺陷。因此，至关重要的是，我们确定所有OME的儿童的听力状态并了解 听力损失对长期结局的影响的变化与程度和对称性的关系 损失。尽管当前的诊断工具通常可以表明存在或不存在OME 我们确定与CHL相关的存在，程度和对称性的能力的显着限制 由于幼儿行为听力学测试的挑战，因此没有客观的替代方案 目前存在行为测试。此外，即使在行为上可以确定听力状态的情况下， 确定听力在一个时间点并不表示听力阈值或风险的稳定性和 长期赤字的大小。我们的长期目标是全面解决这些知识差距 通过确定最有可能长期缺陷的儿童来改善治疗方法来完善临床实践指南 建议。第一步，该提案的主要目的是改善诊断和 了解OME及其相关的听力损失，并研究累积变异性的影响 在一个ome，双耳加工的后遗症上剥夺了听觉剥夺。在AIM 1中，我们将发展一个无创的 客观估计听力损失是由于OME引起的。在AIM 2中，我们将表征短期稳定性和 OME及其相关的听力损失的持久性，并确定非侵入性测量的预后价值 中耳力学。在AIM 3中，我们将确定与OME相关的CHL和中间变化的影响 耳朵机制关于双耳处理的个体差异。这些目标的完成将达到第一步 朝着我们的长期目标，即了解OME的后果和开发工具以识别儿童 通过提高我们客观地确定预后和听力的能力，大多数人都有负后遗症的风险 随着时间的流逝状态，并提高我们对这些因素如何促进长期变异性的理解 术语成果。