Hearing loss is the third most prevalent chronic condition in older Americans, after hypertension and arthritis 1 ; between 25% and 40% of the population aged 65 years or older is hearing impaired. 1-4 The prevalence rises with age, ranging from 40% to 66% in patients older than 75 years 5-7 and more than 80% in patients older than 85 years. 3 Alternative definitions of hearing loss would raise estimates of prevalence even higher. 8 In addition, the impact of hearing loss on society will increase not only because the population is aging, but also because the prevalence of age-adjusted hearing loss has increased significantly since the 1960s. 9,10 The diminished ability to hear and to communicate is frustrating in and of itself, but the strong association of hearing loss with depression and functional decline adds further to the burden on individuals who are hearing impaired. 11-16 Hearing loss in older patients strongly correlates with depression. For example, in a study of 253 patients aged 70 years or older, a strong statistical association was reported between the threshold of a low-frequency pure tone greater than 35 dB and depression. 17 In addition, a crosssectional study of 1191 communitydwelling older persons aged 70 to 75 years found that hearing impairment was significantly associated with depression as assessed by the Beck De

2b.

The diagnosis of AOM confers a significant incremental health-care utilization burden on both patients and the health care system. With its high prevalence across the United States, pediatric AOM accounts for approximately $2.88 billion in added health care expense annually and is a significant health-care utilization concern.

Significant disparities, particularly with respect to household income, exist in the incidence of revisits and complications after pediatric tonsillectomy. The disparate burden of increased revisits and acute pain diagnoses after tonsillectomy deserve further attention.

2C.