To determine the long-term change in static admittance values of subjects with a positive or negative history of otitis media (OM) and ventilation tube (VT) insertion; and to investigate the association between static admittance values and tympanic membrane abnormalities. Design: Prospective follow-up study. Subjects: A total of 358 subjects with or without a history of OM (OMϩ or OM−) and VT insertion (VTϩ or VT−) derived from a birth cohort that had been observed from preschool to adulthood. Main Outcome Measures: Otomicroscopic and tympanometric data obtained at subject ages 8 and 18 years. Results: Static admittance values generally increased with age. At age 8 years, static admittance values were highest in OMϩVTϩ ears and lowest in OM− ears. At age 18 years, the difference between OMϩVTϩ and OMϩVT− ears was larger, while the difference in static admittance values between OMϩVT− and OM− ears had disappeared. In the group of VTϩ subjects, the proportion of extreme static admittance values increased from 16% to 35% between ages 8 and 18 years. Correlation coefficients of individual static admittance values at 8 and 18 years were high in all groups and ranged from 0.61 to 0.85. We could not demonstrate an intermediate role of tympanic membrane abnormalities in the relation between VTs and static admittance at young adult age, except for atrophy. Conclusions: The static admittance value at age 8 years was a strong predictor for the value at age 18 years. A VTϩ status was associated with a larger increase in static admittance than can be explained on the basis of age alone.
Objective: To determine mean hearing thresholds for 18-year-old, otologically healthy subjects. Study design:Prospective historical cohort study. Methods:As part of a follow-up study of a birth cohort, followed from age 2 to 18 years, meticulous otological examination including history-taking, otoscopy, and audiometry were available. At age 18, both air-conduction thresholds (0.25 kHz to 8 kHz and 8 kHz to 16 kHz) and bone-conduction thresholds (0.5 kHz to 4 kHz) were measured. Subjects of this cohort were defined as otologically healthy if they had not experienced substantial otitis media in childhood.Results: On both ends of the frequency range of air-conduction testing, measured thresholds deviated statistically significantly from the ISO 389 reference zero. The air-conduction thresholds were comparable to data presented in the literature. Furthermore, a misfit with the ISO 389 reference was found at 2 and 3 kHz for bone-conduction testing. Only the mean boneconduction thresholds at 0.5 kHz and 4 kHz were not significantly different from the ISO 389 reference zero. To explain the deviations at high frequencies, noise exposure was considered but thought unlikely.Conclusions: This study cohort seems to be the best representative sample so far of otologically healthy subjects due to the longitudinal study of their otological status. Mean hearing thresholds at age 18 are different from the ISO 389 reference zero, suggesting once more the need to revise this ISO norm.
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