No abstract

No abstract

ABSTRACT. Objective. To study the effectiveness of ventilation tubes on the language development in infants with persistent otitis media with effusion (OME). All existing studies addressed children 3 years of age or older. Currently, OME is detected and treated with ventilation tubes at a younger age. Because of the critical relationship between age, hearing, and language development, we conducted a study of the effects of ventilation tubes on language development in infants 1 to 2 years old with persistent OME.Design. A multicenter, randomized, controlled trial (embedded in a cohort) with 2 treatment arms: 1) treatment with ventilation tubes (VT group; n ‫؍‬ 93); or 2) with a period of watchful waiting (WW group; n ‫؍‬ 94). Hearing loss and expressive and comprehensive language were assessed every 6 months, while tympanometry and otoscopy were performed every 3 months. Other factors with potential influence on language development were also included: adenoidectomy, hospital, attending day care, sex, age at randomization, educational level of the mother, upper respiratory infections, and the native country of the parents and older siblings. The trial was designed to allow for the detection of a mean difference in language development of 3 months or more between children allocated to the VT and WW groups.Results. No relevant differences were found in expressive or comprehensive language between the 2 groups after adjustment for educational level of the mother, IQ of the child, and differences at baseline.A principal component analysis showed that in the VT group, the children with frequent complaints improved 1.6 months more in comprehensive language than those with no or some complaints. The children with favorable language stimulation, however, did not improve more than the children with less favorable stimulation. No differences were found for expressive language among the various clusters. The probability to improve >3 months in comprehensive language was .48 (95% confidence interval [CI]: .29 -.68) for children with highly educated mothers versus .09 (95% CI: .02-.30) for children whose mothers had a low educational level. In the WW group, these changes were .30 (95% CI: .14 -.53) and .14 (95% CI: .04 -.35), respectively. The probability to improve >4 months in expressive language was .52 (95% CI: .32-.71) for children with highly educated mothers versus .06 (95% CI: .01-.31) for children whose mothers had a low educational level. In the WW group these changes were .42 (95% CI: .23-.64) and .11 (95% CI: .03-.35), respectively. In addition, there were delays in expressive language in both groups compared with their age expected values.The comprehensive language of the children who were effusion-free during the follow-up (n ‫؍‬ 54) improved 1.5 months (95% CI: ؊.2-3.2) more than that of the children who had persistent effusion during the entire follow-up (n ‫؍‬ 28). No differences were found for expressive language development.Disregarding the intervention contrast, improvements in hearing seemed to be related...

This study aimed at validating an existing health-related quality of life questionnaire for patients with facial palsy for implementation in the Dutch language and culture. The Facial Clinimetric Evaluation Scale was translated into the Dutch language using a forward–backward translation method. A pilot test with the translated questionnaire was performed in 10 patients with facial palsy and 10 normal subjects. Finally, cross-cultural adaption was accomplished at our outpatient clinic for facial palsy. Analyses for internal consistency, test–retest reliability, construct validity and responsiveness were performed. Ninety-three patients completed the Dutch Facial Clinimetric Evaluation Scale, the Dutch Facial Disability Index, and the Dutch Short Form (36) Health Survey. Cronbach’s α, representing internal consistency, was 0.800. Test–retest reliability was shown by an intraclass correlation coefficient of 0.737. Correlations with the House–Brackmann score, Sunnybrook score, Facial Disability Index physical function, and social/well-being function were −0.292, 0.570, 0.713, and 0.575, respectively. The SF-36 domains correlate best with the FaCE social function domain, with the strongest correlation between the both social function domains (r = 0.576). The FaCE score did statistically significantly increase in 35 patients receiving botulinum toxin type A (P = 0.042, Student t test). The domains ‘facial comfort’ and ‘social function’ improved statistically significantly as well (P = 0.022 and P = 0.046, respectively, Student t-test). The Dutch Facial Clinimetric Evaluation Scale shows good psychometric values and can be implemented in the management of Dutch-speaking patients with facial palsy in the Netherlands. Translation of the instrument into other languages may lead to widespread use, making evaluation and comparison possible among different providers.

Nasal congestion is an important symptom in nasal pathology and can be defined as an objective restriction of nasal cavity airflow because of mucosal pathology and/or increased mucus secretion (excluding anatomical variants). Using the new Grading Recommendations Assessment, Development and Evaluation system, evidence‐based recommendations are made that will encompass different clinical questions regarding diagnostic modalities of nasal congestion: (i) their usefulness in assessment of presence and severity of congestion; (ii) their usefulness in assessment of etiological pathology responsible for congestion; and (iii) their usefulness in follow up and treatment effectiveness evaluation of nasal congestion.

Aims-To study the eVect of treatment with ventilation tubes on quality of life in children aged 1-2 years with persistent otitis media with eVusion (OME), as compared to watchful waiting. Methods-Multicentre randomised controlled trial (n = 187) with two treatment arms: ventilation tubes and watchful waiting. Children were detected by auditory screening at the age of 9-12 months, and were subsequently diagnosed as having persistent (4-6 months) bilateral OME. Quality of life (TAIQOL and Erickson scales) was measured at 0, 6, and 12 months follow up.Results-There was improvement in quality of life, but the ventilation tube group did not improve significantly more than the watchful waiting group. Although an attempt has been made to identify possible subgroups that benefit more, we were not able to find such subgroups, which might be a result of lack of power in this study. Conclusion-Ventilation tubes do not have a substantial incremental eVect on the quality of life of infants aged 1-2 years with uncomplicated persistent bilateral OME. (Arch Dis Child 2001;84:45-49) Keywords: otitis media with eVusion; ventilation tubes; randomised controlled trial; quality of life Otitis media with eVusion (OME), common in childhood, is usually associated with mild to moderate hearing loss. Over the past three decades, much research has been done into the eVects of OME on children's development. 1Several studies showed impaired developmental outcomes, but others failed to show such associations.

This study found significant improvement when measuring QoL before and after different treatment modalities in patients with peripheral facial palsy. Future research should focus on patients with PFP due to the same etiology and use of valid QoL instruments for outcome measures. Laryngoscope, 127:1044-1051, 2017.

It is known that insertion of ventilation tubes can cause damage to the tympanic membrane and hearing deterioration in the long-term. To investigate long-term effects of recurrent otitis media and of ventilation tube insertion, we used a study group (n = 358 subjects), with or without a history of otitis media and/or ventilation tube insertion, derived from a birth cohort that had been followed for 16 years. At 18 years of age, a standardized audiometric and otoscopic examination was performed. We found that ventilation tube insertion in childhood was associated with a mean persistent hearing loss in young adults of about 5 to 10 dB at the group level with a sensorineural component of 3 to 4 dB. This hearing loss could not be explained by the disease load of otitis media in childhood. Repeated insertions of ventilation tubes caused a greater deterioration of hearing than did a single insertion. Structural changes of the tympanic membrane were a mediating factor in the causal relationship between ventilation tube insertion and hearing loss. We conclude that ventilation tube insertion in childhood may induce hearing deterioration in the long-term.