Titanium Prostheses for Treating Posttraumatic Ossicular Chain Disruption.

BACKGROUND: Posttraumatic chain disruption may be caused by blunt head trauma, barotrauma, or a penetrating foreign body. In cases of severe damage to the incus, or its absence, a titanium prosthesis is a good option for reconstructing the ossicular chain. METHODS: A retrospective analysis was performed on 24 cases of posttraumatic ossicular chain disruption that had been treated with a titanium partial or total ossicular replacement prosthesis. Air conduction, bone conduction, and air-bone gap were measured before, 6-12 months after, and more than 2 years after the operation. Hearing thresholds were calculated as the mean of 4 frequencies (0.5, 1, 2, and 4 kHz). RESULTS: The most common cause of ossicular chain disruption was blunt head trauma due to a traffic accident (9 of 24 cases), and there were also a diverse group of foreign bodies which caused damage. In cases where the incus was absent, or significantly damaged, titanium ossiculoplasties were performed (partial or total ossicular replacement prosthesis depending on the presence of the stapes superstructure). Analysis showed a significant improvement in average air conduction threshold and in air-bone gap after surgery (P < .05). Closure of the air-bone gap to within 20 dB was observed in 67% of patients. CONCLUSIONS: Although posttraumatic ossicular chain disruption is not common, it is suspected whenever conductive hearing loss persists for several months after injury. In such cases, ossiculoplasty with a titanium prosthesis is likely to provide satisfactory audiological results.

Results of Hearing Screening in School-Age Children from Rural Areas of the Kujawsko- Pomorskie Region in Poland.

OBJECTIVE: There is a need for regular surveillance of the hearing of children, no matter what their age. Screening of the hearing of school children can be done quickly and cheaply using teleaudiology. The primary aim of this study was to identify children who showed a suspected hearing impairment from rural areas of the Kujawsko-Pomorskie region and refer them for further audiological testing. A secondary aim was to estimate the prevalence of hearing loss in those children. METHODS: There were 4754 children, made up of 1840 children aged 6-7 years old and 2914 children aged 12-13 years old. Pure-tone air conduction thresholds were obtained at 0.5-8 kHz. Audiometric test was supplemented by results of a brief questionnaire filled in by parents. RESULTS: Of the 4754 children, 618 (13%) failed screening and were referred for detailed audiological diagnostics. The prevalence of hearing loss was estimated to be 7% and was significantly higher (OR = 2.12) in the group aged 6-7 y/o (10.1%) than in the group aged 12-13 y/o (5.0%). In our study the estimated prevalence of HL was twice as high in children aged 6-7 y/o (10.1%) than in children 12-13 y/o (5.0%). This difference was also evident in another study of Polish children from rural areas, where the prevalence of HL was 11.4% in younger children (6-9 y/o) and 5.5% in older children (12-13 y/o). CONCLUSION: Large numbers of school-age children in rural areas have hearing problems. It is recommended that a hearing screening program in primary schools based on e-health solutions should be adopted.