title: Chronic suppurative otitis media, middle ear pathology and corresponding hearing loss in a cohort of Greenlandic children.
abstract: BACKGROUND
  Otitis media (OM) has been observed at elevated prevalence rates in Greenlandic children. OM associated hearing loss (HL) may compromise the children's linguistic skills, social development and educational achievements.
  
  
  OBJECTIVE
  We investigated the prevalence of chronic suppurative otitis media (CSOM), otitis media with effusion (OME) and tympanic membrane sequelae of OM, and compared the corresponding hearing thresholds.
  
  
  METHODS
  In 2010 we examined a cohort of 223 Greenlandic children aged 4-10 years by video otoscopy, tympanometry and tested hearing thresholds for the low-frequencies: 500, 1000 and 2000Hz and the high-frequencies: 4000 and 6000Hz. HL was categorized according to the worst hearing ear and was compared within the groups: CSOM, OME, tympanic membrane sequelae of OM and normal.
  
  
  RESULTS
  Of 207 children, 5.8% had CSOM, 13.9% had OME and 55.6% had tympanic membrane sequelae of OM. The median pure tone average in low-frequencies/high-frequencies were: CSOM: 34.2/31.3dB, OME: 23.3/22.5dB, Sequelae of OM: 13.3/15dB and normal ears: 11.7/12.5dB. We found a significant difference (p<0.05) between the four groups. In 56.5% of all children a HL>15dB in any frequency was found, while 6.5% suffered from a bilateral low-frequency HL>25dB.
  
  
  CONCLUSIONS
  The severity of OM significantly corresponded to increased HL. The burden of CSOM and HL remains high in young Greenlandic children. Aggressive treatment with antibiotics, improved hearing rehabilitation, sound field amplification in classrooms and otosurgical capacity should be further promoted in Greenland.
authors.affiliation: Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Denmark. Electronic address: magnusavnstorp@gmail.com.
authors.forename: Magnus Balslev
authors.initials: MB
authors.lastname: Avnstorp
authors.affiliation: Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Denmark; Department of Otorhinolaryngology and Maxillofacial Surgery, Køge University Hospital, University of Copenhagen, Denmark.
authors.forename: Preben
authors.initials: P
authors.lastname: Homøe
authors.affiliation: National Institute of Public Health, Centre for Health Research in Greenland, University of Southern Denmark, Odense, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Bjerregaard
authors.affiliation: Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Denmark; Department of Otorhinolaryngology and Maxillofacial Surgery, Køge University Hospital, University of Copenhagen, Denmark.
authors.forename: Ramon Gordon
authors.initials: RG
authors.lastname: Jensen
mesh_terms: D000158:Acoustic Impedance Tests; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004432:Ear, Middle / Q000473:pathology*; D005260:Female; D006116:Greenland / Q000453:epidemiology; D034381:Hearing Loss / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D010034:Otitis Media with Effusion / Q000150:complications / Q000453:epidemiology*; D010035:Otitis Media, Suppurative / Q000150:complications / Q000453:epidemiology*; D038781:Otoscopy; D015995:Prevalence; D014432:Tympanic Membrane / Q000473:pathology*
keywords: Chronic suppurative otitis media; Epidemiology; Hearing loss; Inuit; Tympanic membrane pathology; Video otoscopy