A retrospective case record study of 20 patients in Oslo operated on for chronic otitis media with labyrinthine fistula between 1986 and 1999 was performed in order to estimate the incidence of, and identify predictors for, labyrinthine fistulas. The incidence of fistula was 0.3 per 100 000, with a median age at diagnosis of 37 years. The median duration of chronic otitis media prior to labyrinthine fistula detection was significantly correlated with age at surgery. Subjective hearing loss (90%), otorrhoea (65%) and dizziness (50%) were presenting symptoms. Modified canal-wall-down mastoidectomy was performed in all patients. Preoperative hearing levels could not predict postoperative hearing outcome. Positive signs of fistula were found in only 4 patients (20%). Correspondingly, computerized tomography (CT) diagnosed the fistula in 11 patients (55%). The seven patients presenting without dizziness and with a negative CT scan and fistula test were characterized by lower age, absence of previous middle ear surgery, lower preoperative pure-tone thresholds for bone conduction and better hearing outcome after surgery. In conclusion, the identification of a younger group of patients presenting with fewer symptoms indicates that fistulas should be suspected in all patients undergoing surgery for chronic middle ear and mastoid disease.
In order to assess the relationship between recurrent acute otitis media (rAOM) and age at first acute otitis media (AOM) episode, a prospective cohort of 3754 Norwegian children born in 1992-1993 was followed from birth to 2 years. Recurrent acute otitis media was defined by the criterion of four or more episodes of AOM during a 12-month period. Approximately 5.4% of the children experienced rAOM before the age of 2. Furthermore, children whose first AOM episode occurred before the age of 9 months were at a significantly higher risk for developing rAOM compared to children whose first AOM episode was 10-12 months. In children who had the first ear infection during the first 9 months of life, one-quarter developed rAOM before the age of 2. Multiple logistic regression analysis adjusted for confounding showed that gender and a familial history of atopy were significantly associated with rAOM. In conclusion, the present study found an association between age at first AOM episode and the later subsequent AOM proneness. Additionally, both gender and a family history of atopy seemed to predispose towards otitis-proneness.
The temporal bones from 18 deaf Dalmatian dogs were examined with the light microscope, and the cochleo-saccular degeneration process studied. End organ degeneration is already advanced by the age of 4 weeks, whilst loss of neurons in the spiral ganglion was found only in adult animals. Both processes are first evident in the central portion of the cochlea, and increase in extent with advancing age, The implications of these findings for the management of non-conductive hearing loss in man are discussed.
Air-conduction and bone-conduction thresholds have both been determined in the conventional audiometric frequency ranges and in the extended high frequencies through respectively 18 and 16 kHz for otologically healthy subjects in different age groups covering the age span 8-14 years through the eighth decade. Subjects younger than 30 years had conventional frequency air-conduction thresholds < or = 10 dB HL, whereas the corresponding thresholds of older subjects were within 0.1 and 0.9 percentiles of ISO 7029 (1984). Age- and gender-specific thresholds, medians and ranges, are presented for bone conduction in the extended high frequencies. Thresholds increase with both age and frequency in the range 8-16 kHz, and there is a largely non-significant tendency for thresholds to be higher in males. Threshold deterioration at the highest frequencies is already present at age 18-24 years compared with the youngest (8-14 year) age group.
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