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Klausen O, Møller P, Holmefjord A, Reisaeter S, Asbjørnsen A. Lasting effects of otitis media with effusion on language skills and listening performance. Acta Otolaryngol 2000; Suppl 543: 73 -76.Otitis media with effusion (OME) and its related hearing loss has been associated with delayed language development, particularly if the disease is recurrent or of long duration. To find out more about the long-term effects of OME on language skills and listening performance we performed a retrospective study. A group of 19 otherwise healthy 9-year-old children with an earlier history of long lasting bilateral OME were compared with an age-matched control group of 19 children with no history of OME or hearing impairment and normal otoscopy, tympanometry and audiometry. The children in the OME group had an average of 1.4 treatments with ventilation tubes. Mean hearing levels for 500, 1,000 and 2,000 Hz in the OME group were 13 dB in the right ear and 11.3 dB in the left ear. All children were examined with the Illinois test of psycholinguistic abilities (ITPA), test for articulation, Boston naming test, dichotic listening tests with additional tasks of directed attention and tests for word and sound discrimination. In the OME group we found significant lower scores in the articulation test and small, but significant, lower scores in the test regarding sound discrimination. No significant differences on other language skills were detected in the ITPA test or Boston naming test. We found a significantly higher degree of right ear advantage and lower attentional effectiveness in the OME-group.

Dichotic listening performance was studied in children who at an early age had undergone a myringotomy with insertion of ventilating tubes for persistent middle ear infections (otitis media with effusion; OME) and compared with age-equivalent children who had no history of otitis media or hearing problems. The OME group consisted of 19 children with a median age of 9 years; 15 of whom were right-handed, and 14 were boys. The comparison sample comprised 18 children with a median age was 9 years 4 months. Hand preference and sex were matched with the OME group. Both groups were tested with dichotic listening to consonant-vowel syllables and additional forced-attention tasks. The comparison sample showed a weak right-ear advantage, and age-adequate attentional modulations. The children in the OME group showed a strong right-ear advantage, but were not able to modulate the ear advantage during directed-attention tasks. Models for interpreting the result are discussed.

Dichotic listening performance was studied in children who at an early age had undergone a myringotomy with insertion of ventilating tubes for persistent middle ear infections (otitis media with effusion; OME) and compared with ageequivalent children who had no history of otitis media or hearing problems. The OME group consisted of 19 children with a median age of 9 years; 15 of whom were right-handed, and 14 were boys. The comparison sample comprised 18 children with a median age was 9 years 4 months. Hand preference and sex were matched with the OME group. Both groups were tested with dichotic listening to consonant-vowel syllables and additional forced-attention tasks. The comparison sample showed a weak right-ear advantage, and age-adequate attentional modulations. The children in the OME group showed a strong right-ear advantage, but were not able to modulate the ear advantage during directedattention tasks. Models for interpreting the result are discussed.Temporary hearing loss in preschool children may affect language development (Schlieper et al. 1985, Rach et al. 1988, Teele et al. 1990, Roberts et al. 1991. The consequences may be trivial with brief infections, whereas chronic or recurrent infections are often followed by partial conductive hearing loss, resulting in auditory deprivation (Howie 1980), and delayed speech and language development (Schlieper et al. 1985, Maw et al. 1999. However, the effects of early and recurrent otitis media with effusion (OME) on speech and language development are far from clear.Adesman and coworkers (1990) showed that early language development (18 to 24 months) is associated with hearing status at 6 to 12 months of age. In addition, Teele and colleagues (1990) found a positive correlation between duration of middle ear effusion and tests of cognitive skills, language and speech performance, and school achievement. Rach and colleagues (1988) found no effect on verbal comprehension but significantly lower scores for verbal expression in children with a history of OME. However, in a prospective cohort study, Roberts and coworkers (1991) showed no relation between OME and later language development. To date, no data have shown how OME affects the development of language laterality and auditory attentional skills.Dichotic listening implies presentation of two different auditory stimuli simultaneously, one to each ear. The technique has been used for the past three decades to study language processing in the brain, and has gained a reputation as a valid and reliable measure of auditory processing and functional lateralization. Specifically, it has been a popular procedure for assessing language lateralization (Kimura

The present study investigated auditory attention skills in a sample of children with non-chronic otitis media with effusion (OME). Twenty children with repeated episodes of OME but not found in the need for myringotomy and insertion of ventilating tubes were compared to 20 control children with no known episodes of OME based on parental reports and medical records. Mean age during assessment was 9 years, and none of the children showed signs of impaired language functions and with normal general cognitive abilities. They were assessed with dichotic listening CV-syllables (DLCV-108) free recall and directed attention tasks. The control children showed the expected right ear advantage during free recall and the directed right condition, and demonstrated a shift toward a left ear advantage during the directed left. The children with a history of OME showed a predominant right ear advantage across all three tasks. Although some change in ear accuracy occurred across tasks, impaired auditory attention skills were found following a history of middle ear infections. These results replicate those reported earlier from a sample of children with persistent otitis media with effusion, and suggest that treatment with ventilating tubes does not appear to make any difference in the development of auditory attention skills, whereas occurrence of OME must be considered when testing auditory attentional skills as a part of a neuropsychological assessment.

Ornithosis has been a notifiable disease in Norway since 1957. During an outbreak of respiratory disease in 1981-82, described as ornithosis, contact with birds was stated in only 50% of the cases, suggesting that the infection was spread by interhuman transmission. A similar outbreak occurred in the western part of Norway in 1987. Serum specimens from altogether 260 patients, collected during the outbreaks in 1981-82 and in 1987, were investigated for antibodies against Chlamydia pneumoniae (strain TWAR). Evidence of recent infection with C. pneumoniae was found in 67.7% of the cases. The results indicate that the increased incidence of ornithosis in 1981-82 and in 1987 was due mainly to C. pneumoniae infections.

Fifty consecutive patients underwent functional endoscopic sinus surgery (FES) for bilateral rhinosinusitis. Pre- and post-operative computerized tomographic scans were evaluated. Of 50 patients, 45 (90%) experienced improvement in symptoms. Post-operative scans gave less encouraging results, with a slightly improved score for the combined group of sinuses and for the ethmoidal and maxillary sinuses separately. The difference between the pre- and post-operative CT score for the ethmoidal sinuses was statistically significant. The frontal sinus showed similar pre- and post-operative radiological findings. For the inexperienced surgeon we recommend computer tomographic examination 4-6 months after surgery. This could prove helpful if recurrence of symptoms occurs. For the experienced surgeon, clinical and endoscopic follow-up for at least 3 years is appropriate.

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