Acute otitis media (AOM) and otitis media with effusion (OME) are common infections in children, and their diagnosis and treatment have significant impacts on the health of children and the costs of providing national medical care. In 2009, the Korean Otologic Society organized a committee composed of experts in the field of otolaryngology, pediatrics, and family medicine to develop Korean clinical practice guidelines (CPG) for otitis media in children with the goal of meeting regional medical and social needs in Korea. For this purpose, the committee adapted existing guidelines. A comprehensive literature review was carried out primarily from 2004 to 2009 using medical search engines including data from Korea. A draft was written after a national questionnaire survey and several public audits, and it was editorially supervised by senior advisors before publication of the final report. These evidence-based guidelines for the management of otitis media in children provide recommendations to primary practitioners for the diagnosis and treatment of children younger than 15 yr old with uncomplicated AOM and OME. The guidelines include recommendations regarding diagnosis, treatment options, prevention and parent education, medical records, referral, and complementary/alternative medicine for treating pediatric otitis media.
Background and ObjectivesZZThere are two ways to route sound from a deaf hemifield to a functional ear: the bone anchored hearing aid (BAHA) and the contralateral routing of signal hearing aid (CROS HA). BAHA uses transcranial bone conduction; on the other hand, CROS HA uses air conduction. The objectives of this study were to evaluate the benefit of these auditory rehabilitation devices objectively and subjectively, and to analyze factors that affect daily using time. Subjects and MethodZZWe retrospectively reviewed the medical records of 19 patients who selected BAHA and 9 patients who selected CROS HA to undergo rehabilitation of unilateral hearing loss. Preoperative pure tone air and bone conduction thresholds, BAHA-aided thresholds and CROS HA-aided thresholds were measured. Hearing in noise test (HINT) was measured with unaided and aided in signal to noise ratio 10 (signal 75 dB HL, noise 65 dBA). Bern Benefit in Single-Sided Deafness Questionnaire (BBSS) was evaluated for all patients to assess subjective satisfaction and also, daily device using time was investigated. ResultsZZThe aided pure tone audiometry was 44.58 dB HL, 42.71 dB HL for in BAHA and CROS HA, respectively, whereas the unaided PTA was 111.29, 103.28 dB HL for BAHA and CROS HA, respectively. The aided HINT was 63.03 and 64.06%, whereas the unaided HINT was 22.13% and 37.44% for BAHA and CROS, respectively. BBSS showed more satisfactory results with BAHA and CROS HA when compared unaided in all items. Daily using time did not correlate with the degree of satisfaction, better ear hearing levels or etiology. ConclusionZZIt was found that not only the preoperative BAHA rod test and HA trials but also the customized and detail counseling were needed for single sided deaf patients to use auditory rehabilitation devices frequently.
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