Innovative £50 headset and free app sent by post to manage glue ear -the most common childhood hearing loss- when services were closed during the C19 pandemic

BackgroundHearing loss from glue ear affects ∼1 in 10 children starting school in UK/Europe. Of all children globally with a hearing loss, fewer than 10% of children have access to hearing aids: affordable solutions are needed. Studies showed children with OME hear better with bone conducting headsets. During COVID-19 we investigated whether children with glue ear (also known as Otitis Media with Effusion, OME) without access to audiology or grommet surgery during the Covid pandemic, could be aided remotely with £50 bone conduction kits and the HearGlueEar app.ObjectivesCould families pair and set up a product set (requiring Bluetooth connectivity) themselvesCould children’s quality of life be improved with remotely managed hearing support.Can glue ear be successfully managed remotely.Does this management affect the number of grommet operations required?MethodsStarting July 2020, during COVID-19, children aged 3–11 years with OME and on a grommet waiting list were invited to a single arm, prospective study. They received the kit, instructions and HearGlueEar app by post. By 3 weeks parents were asked to charge and pair the devices, attend a remote consultation and complete an OMQ-14 questionnaire. Remote follow-up lasted 3 months.Results82% (26 children) of those waiting for grommet operation list at the time of first lockdown in 2020 joined the study.Children experienced more challenging listening situations during the pandemic with remote learning, social distancing and masks obscuring lip reading.Families and the children felt empowered to manage their child’s condition at home and school.100% of families set up the product set remotely without professional help. Although some families needed additional support through the study therefore contact with a professional to trouble shoot was important.Quality of life (OMQ-14) responses were 90% positive. Comments included: ‘Other people have said, wow his speech is clearer.’, ‘It is making a real difference at home.’, ‘He said over and over again, ‘I can hear everybody, wow.’, ‘It is no exaggeration to say this has made an astronomical improvement to his quality of life’. ‘She is getting on really well with the headphones - pairing them with the iPad at home is simply brilliant.’ One child said ‘I can hear my best friend again’.20% of those in the study avoided grommet operations: either choosing this management option as an alternative or successfully supporting their child’s hearing until the glue ear self-resolved.ConclusionsPosting a bone conduction kit, HearGlueEar app and remote consultation is an effective management option for children with glue ear. This reduced the need for some grommet operations affording cost-savings and relieved hospital waiting lists. Children’s hearing was supported at home and at school as well as challenges experienced in the pandemic with on-line education, social distancing and communicating with face coverings.https://medrxiv.org/cgi/content/short/2021.01.21.21249496v1