title: Parental suspicion of hearing loss in children with otitis media with effusion.
abstract: OBJECTIVE
  This study aimed to evaluate the parental suspicion of hearing loss in children with otitis media with effusion (OME). As part of a population-based survey in a screening programme among 6- to 7-year-old Chinese children in Hong Kong, OME cases and controls were studied for the value of parental observations in the prediction of OME and hearing test results.
  
  
  METHODS
  Prior to the otoscopic and tympanometric examination of the children on school premises, a self-administered binary-choice question was sent to the parents asking whether there was any suspicion of hearing impairment. Positive screens and randomly selected negative screens were seen in a hospital clinic for the confirmation of case and control status 2 to 3 weeks after the school screening. Aural examination under microscopy, repeated tympanometry and stapedial reflex testing, and pure-tone audiometry (PTA) were conducted, and 117 cases and 159 controls were included in this study.
  
  
  RESULTS
  The average PTA conductive threshold levels in the individual children with OME ranged from 3.8 dB to 40.0 dB with a group mean of 17.0 dB in the better-hearing ears. Parental suspicion of hearing deficit was significantly associated with OME (p<0.001) but not PTA findings (p=0.686). The sensitivity of parent-suspected hearing impairment to detect OME however was very low (19.7%).
  
  
  CONCLUSIONS
  In other words, if we had relied on parental suspicion as the first screening, at least 80% of the OME cases would have been missed. We conclude that the parental suspicion of hearing loss is inadequate for the identification of mild hearing loss as caused by OME. Health education is recommended to improve parental awareness of the disease.
authors.affiliation: Division of Otorhinolaryngology, Department of Surgery and Institute of Human Communicative Research, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, People's Republic of China. sylo@cuhk.edu.hk
authors.forename: Phoebe S Y
authors.initials: PS
authors.lastname: Lo
authors.forename: Michael C F
authors.initials: MC
authors.lastname: Tong
authors.forename: Eric M C
authors.initials: EM
authors.lastname: Wong
authors.forename: C Andrew
authors.initials: CA
authors.lastname: van Hasselt
mesh_terms: D001309:Auditory Threshold; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006314:Hearing Loss, Conductive / Q000175:diagnosis* / Q000209:etiology; D006320:Hearing Tests; D006723:Hong Kong; D006801:Humans; D008297:Male; D010034:Otitis Media with Effusion / Q000150:complications / Q000175:diagnosis*; D038781:Otoscopy; D010290:Parents; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires