Contribution of Treatment with Ear Popper for Hearing in Children with Middle Ear Effusion.

OBJECTIVES: we aim to assess the contribution of the EarPopper device to hearing in children with middle ear effusion (MEE). METHODS: The study has three parts, including 1. tympanometry and audiometry before and six weeks after using the EarPopper to evaluate the treatment's effect over time compared to a control group; 2. tympanometry before and immediately after using the EarPopper to evaluate immediate changes in middle ear pressure (MEP); 3. length of effect 90 min after use to assess pressure fluctuations over time. RESULTS: Part 1 was a follow-up six weeks after using the device, and the patients in the study group that completed the study showed a significant improvement in hearing threshold. The average gain in hearing threshold ranged from 9.1 dB to 14 dB compared to the control group's max improvement of 1.1 dB. In addition, MEP was significantly improved in the study group, as most Type Bs improved to Type A and C. Part 2 was the tympanometry immediately after using EarPopper and showed the majority of Type Cs turned into Type As. The majority of Type Bs remained unchanged. Part 3 was a follow-up 90 min after use; Type Cs that had improved to Type A demonstrated a decrease in pressure and return to negative pressure. CONCLUSIONS: use of the EarPopper device for six weeks is associated with an improved hearing threshold and middle ear status.

The Complexity of Hearing Aid Fitting: Children with Congenital Hearing Loss and Middle Ear Dysfunction.

BACKGROUND: The early diagnosis of hearing loss (HL) and hearing rehabilitation facilitate language and communication development. Some children exhibit mixed HL due to middle ear effusion (MEE) or acute otitis media (AOM). Mixed HL can affect HL evaluation and hearing aid (HA) fitting. The present study retrospectively evaluated the prevalence of MEE/AOM among children with congenital sensorineural HL (SNHL) who were fitted with HAs and its effect on the HA fitting. METHODS: Thirty-six HA fittings carried out between 2017 and 2020 at one rehabilitation center were examined. Medical and audiological information was retrieved for children between 6 and 32 months old. The number of appointments and HA fitting times were recorded. RESULTS: Twenty-eight children were included in the study. Eighteen children, in addition to SNHL, had a conductive component resulting from MEE/AOM. The children with these pathologies required significantly more HA fitting sessions and hearing tests, fewer real ear to coupler difference (RECD) measurements and longer HA fitting periods. CONCLUSION: The findings indicate that a large number of children fitted with HAs have an additional conductive component that makes the fitting process longer. Since early rehabilitation is necessary for language development, otolaryngologists should be aware of the adverse effects of MEE/AOE on the HA fitting process. It is important to inform parents that when there is a conductive component, the HA fitting process may take longer and that treatment by an otolaryngologist is vital. This study stresses the importance of multidisciplinary cooperation for optimal HA fitting.

Mechanisms responsible for postnatal middle ear amniotic fluid clearance.

Neonatal guinea pigs show signs of a temporary conductive hearing loss during the first few days after birth. It has been suggested that this is due mainly to the presence of amniotic fluid in the middle ear (ME) cavity at birth and its subsequent clearance. This study was designed to try to identify the mechanisms responsible for the amniotic fluid clearance from the ME after birth by means of several experiments in guinea pigs. The osmolarity of the blood, amniotic fluid and the fluid in the ME cavity of guinea pig fetuses was measured. Serum and normal saline were introduced into the ME of older animals and fluid clearance was monitored short- and long-term by microscopic observation, tympanometry and estimation of residual fluid. Following instillation of 1/5 normal saline and normal saline into the ME cavity, the osmolarity of the remaining fluid was determined, short- and long-term. Clear osmotic pressure gradients were found between amniotic fluid (low pressure), fetal blood (higher pressure) and the fluid in the fetal ME (intermediate between them). The MEs into which normal saline had been introduced developed negative pressure and, over several days, were cleared of fluid. When serum was applied, ME pressure remained close to atmospheric and the fluid was not cleared. Hypotonic saline application led to an increase in the osmotic pressure in the fluid remaining in the ME. It is concluded that most of the amniotic fluid is cleared from the neonatal ME cavity by water outflow into the blood due to osmotic pressure gradients.

An animal model for assessment of amniotic fluid clearance from the middle ear.

HYPOTHESIS: To determine the time needed for clearance of amniotic fluid from the middle ear after birth, an animal model study was performed. BACKGROUND: Before birth, the middle ear is full of amniotic fluid, and there is controversy about the time it takes for it to clear postnatally. This is of importance because it is suspected that amniotic fluid in the middle ear of the newborn may affect results of screening of hearing when using otoacoustic emissions. METHODS: Adult and neonatal guinea pigs underwent a right-side cochleotomy followed by baseline otoscopy, tympanometry, and auditory nerve- and brainstem-evoked response (ABR) measurements of the left ear. Subsequently, the animals' left middle ears were filled with saline through a hole drilled in the bulla. Over the next few days, assessment of saline clearance was conducted by repeated left-side otoscopy, tympanometry, and measurement of ABR. RESULTS: After filling the middle ear with saline, the tympanic membrane was opaque, a type B tympanogram was obtained, and the ABR threshold was elevated. After an average of 6.3 +/- 3.0 days, air bubbles were seen in otoscopy, a type C tympanogram was obtained, and the ABR threshold improved. Finally, after an average of 9.5 +/- 2.7 days, all 3 parameters returned to their baseline values. CONCLUSION: Taking into consideration that this is an animal study, the results suggest that clearance of amniotic fluid from the newborn middle ear takes longer than has been generally thought. In addition, an animal model for assessing the clearance of fluid from the middle ear has been developed.