There is high morbidity and mortality associated with skull base osteomyelitis. In partially treated cases of malignant otitis externa, atypical symptoms and findings of unilateral severe otalgia, unremitting headache, and presence of high ESR, unilateral OME, constitute diagnostic clues of skull base osteomyelitis. Such cases require further investigation with CT, MRI, Technetium 99 and gallium 67 scintigraphy and aggressive management.
A community-based nationwide survey for hearing loss was conducted in Oman in 1996-97. Audiometric tests and ear examinations were conducted for 12,400 persons in phase I. For children aged less than 4 years, subjective screening tests were used. In phase II, otologists examined the hearing-impaired subjects to determine the cause. The prevalence of bilateral hearing impairment was 55/1000 (95% CI 51.08-59.47). Gender difference was not significant. The rates were 325/1000 and 17/1000, respectively, in the > or = 60-year and < 10-year age groups. Presbyacusis and middle ear diseases, respectively, were the causes of 33% and 20% of bilateral hearing impairment. In 30% of the bilateral hearing-impaired subjects, the cause could not be determined. The prevalence of bilateral disabling hearing loss was 21/1000 (95% CI 18.07-23.29). Noise-induced trauma was responsible for only 1.4% of cases of disabling hearing loss. Establishing primary ear care, introducing hearing screening for neonates and schoolchildren, promoting safe preventive practices for ear care, strengthening secondary-level ear care services and introducing comprehensive rehabilitative initiatives for the hearing-disabled are recommended to reduce the hearing loss rates.
This study was based on a national retrospective analysis of 1400 questionnaires on the causes of deafness in Omani children, collected from 1986 to 2000. It was found that 70% of the deaf children were from parents of consanguineous marriages, and 30% from non-consanguineous unions. In those with consanguineous families 70.16% were first cousin marriages, 17.54% were second cousins, and 10.86% were from the same tribe. The proportion arising from first cousin marriages was higher than the background rate of first cousin marriages in Oman. In the total cohort, 45% had other family members with hearing loss. There was a greater chance of other relatives being affected in the consanguineous group as opposed to the non-consanguineous group (29.7% versus 15.3%). In most cases the affected relative was a deaf sibling (67.8%). We have demonstrated a higher rate of consanguinity amongst parents of deaf children in Oman and suggest this is associated with a higher frequency of autosomal recessive deafness in this paediatric population.
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