Central auditory processing in teenagers with non-cholesteatomatous chronic otitis media<sup>,</sup>

Machado, Márcia Salgado; Teixeira, Adriane Ribeiro; Costa, Sady Selaimen da

doi:10.1016/j.bjorl.2019.02.006

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Brazilian Journal of Otorhinolaryngology

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Original articles • Braz. j. otorhinolaryngol. 86 (5) • Sep-Oct 2020 • https://doi.org/10.1016/j.bjorl.2019.02.006 copy

Central auditory processing in teenagers with non-cholesteatomatous chronic otitis media^☆ ☆ Please cite this article as: Machado MS, Teixeira AR, Costa SS. Central auditory processing in teenagers with non-cholesteatomatous chronic otitis media. Braz J Otorhinolaryngol. 2020;86:568-78. ^,^☆ ☆☆ Study conducted at Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction:

Evidences of possible effects of early age otitis media with effusion in the central auditory processing, emphasize the need to consider such effects also in subjects with chronic otitis media.

Aim:

To investigate and analyze the impact of non-cholesteatomatous chronic otitis media on central auditory processing in teenagers.

Methods:

This is a study in which 68 teenagers were recruited, 34 with a diagnosis of non-cholesteatomatous chronic otitis media (study group) and 34 without otological disease history (control group). The evaluation of the subjects consisted of: anamnesis, pure-tone threshold audiometry, speech audiometry and a behavioral test battery for assessment of central auditory processing.

Results:

A statistically significant difference was found between the means observed in the study and control groups in all tests performed. An association was found between the control group and subgroups of the study group with unilateral alterations in all tests. An association was shown between the results for the control group and study group for family income, with a greater impact on subjects with a lower income.

Conclusions:

Non-cholesteatomatous chronic otitis media affects the central auditory processing in teenagers suffering from the disorder, and monaural low-redundancy hearing is the most affected auditory mechanism. Unilateral conductive changes cause more damage than bilateral ones, and lower family income seems to lead to more changes to the central auditory processing of subjects with non-cholesteatomatous chronic otitis media.

KEYWORDS
Auditory perception; Otitis media; Auditory perception disorders; Central auditory diseases; Teenager

Variables	Study group (n = 34)	Control group (n = 34)	p
Age (years) - average ± SD	14.9 ± 2.1	15.1 ± 2.1	0.569
Gender - n (%)			1.000
Male	22 (64.7)	22 (64.7)
Female	12 (35.3)	12 (35.3)
Years of schooling - average ± SD	8.8 ± 1.9	9.3 ± 2.3	0.308
Age of onset OM - average ± SD	2.24 ± 1.8	-
Maternal schooling - n (%)			0.452
Incomplete elementary school	15 (44.1)	11 (32.4)
Complete elementary school	3 (8.8)	1 (2.9)
Incomplete high school	5 (14.7)	6 (17.6)
Complete high school	11 (32.4)	16 (47.1)
Family income - n (%)			0.865
Vulnerable	16 (47.1)	17 (50.0)
Low middle class	12 (35.3)	10 (29.4)
Middle class middle	6 (17.6)	7 (20.6)
AC - average ± SD
RE	21.2 ± 10.8	5.9 ± 3.9	<0.001^a a p ≤ 0.05 (level of statistical significance).
LE	21.2 ± 11.4	5.7 ± 3.4	<0.001^a a p ≤ 0.05 (level of statistical significance).
Gap - average ± SD
RE	19.3 ± 9.6	-
LE	17.7 ± 9.0	-

Variables	Study group (n = 34)	Control group (n = 34)	p ^a a p ≤ 0.05 (level of statistical significance).	Effect size
SSI 0 - average ± SD
RE (%)	53.2 ± 15.5	100 ± 0.0	<0.001	4.27
LE (%)	53.5 ± 15.2	100 ± 0.0	<0.001	4.33
SSI-15 - average ± SD
RE (%)	29.1 ± 15.8	96.2 ± 6.0	<0.001	5.63
LE (%)	31.8 ± 15.3	95.3 ± 6.1	<0.001	5.46
DD - average ± SD
RE (%)	96.3 ± 4.6	99.3 ± 1.1	0.001	0.90
LE (%)	97.6 ± 3.0	99.4 ± 1.1	0.003	0.80
DPS - average ± SD (%)	45.6 ± 22.1	61.8 ± 18.0	0.002	0.81
MLD - average ± SD (dB)	9.2 ± 3.6	11.5 ± 1.3	0.001	0.85
RGDT - average ± SD (ms)	14.1 ± 6.4	4.1 ± 1.6	<0.001	2.15

Variables	Control group (n = 34)	UNICON subgroup (n = 15)	p ^a a p ≤ 0.05 (level of statistical significance).	BILCON subgroup (n = 19)	p
SSI 0 - average ± SD
RE (%)	100 ± 0.0	50.7 ± 10.3	<0.001	55.3 ± 18.7	<0.001^a a p ≤ 0.05 (level of statistical significance).
LE (%)	100 ± 0.0	52.7 ± 10.9	<0.001	54.2 ± 18.0	<0.001^a a p ≤ 0.05 (level of statistical significance).
SSI-15 - average ± SD
RE (%)	96.2 ± 6.0	27.3 ± 13.9	<0.001	30.5 ± 17.5	<0.001^a a p ≤ 0.05 (level of statistical significance).
LE (%)	95.3 ± 6.2	28.7 ± 9.2	<0.001	34.2 ± 18.7	<0.001^a a p ≤ 0.05 (level of statistical significance).
DD - average ± SD
RE (%)	99.3 ± 1.1	95.2 ± 5.9	<0.001	97.2 ± 3.1	0.054
LE (%)	99.4 ± 1.1	97.2 ± 3.4	0.004	98.0 ± 2.7	0.068
DPS - average ± SD (%)	61.8 ± 18.0	46.4 ± 23.1	0.034	44.9 ± 21.9	0.010^a a p ≤ 0.05 (level of statistical significance).
MLD - average ± SD (dB)	11.5 ± 1.3	8.4 ± 3.6	0.001	9.9 ± 3.5	0.082
RGDT - average ± SD (ms)	4.1 ± 1.6	13.0 ± 6.9	<0.001	15.1 ± 5.9	<0.001^a a p ≤ 0.05 (level of statistical significance).

Variables	Vulnerable		p ^a a p ≤ 0.05 (level of statistical significance).	Low middle class		p	Middle class middle		p
Variables	SG (n = 16)	CG (n = 17)	p ^a a p ≤ 0.05 (level of statistical significance).	SG (n = 12)	CG (n = 10)	p	SG (n = 6)	CG (n = 7)	p
SSI 0 dB average ± SD
RE (%)	50.0 ± 13.2	100 ± 0.0	<0.001	60.8 ± 15.1	100 ± 0.0	<0.001^a a p ≤ 0.05 (level of statistical significance).	46.7 ± 18.6	100 ± 0.0	<0.001^a a p ≤ 0.05 (level of statistical significance).
LE (%)	51.9 ± 11.7	100 ± 0.0	<0.001	59.2 ± 16.2	100 ± 0.0	<0.001^a a p ≤ 0.05 (level of statistical significance).	46.7 ± 19.7	100 ± 0.0	<0.001^a a p ≤ 0.05 (level of statistical significance).
SSI-15 dB average ± SD
RE (%)	28.8 ± 18.2	95.9 ± 6.2	<0.001	30.0 ± 11.3	94.0 ± 7.0	<0.001^a a p ≤ 0.05 (level of statistical significance).	28.3 ± 19.4	100 ± 0.0	<0.001^a a p ≤ 0.05 (level of statistical significance).
LE (%)	30.6 ± 12.9	95.9 ± 6.2	<0.001	35.8 ± 15.6	93.0 ± 6.7	<0.001^a a p ≤ 0.05 (level of statistical significance).	26.7 ± 20.7	97.1 ± 4.9	<0.001^a a p ≤ 0.05 (level of statistical significance).
DD average ± SD
RE (%)	94.5 ± 5.6	99.3 ± 1.2	0.005	97.5 ± 2.8	99.3 ± 1.2	0.083	98.8 ± 2.1	99.6 ± 0.9	0.368
LE (%)	97.0 ± 3.4	99.6 ± 1.0	0.011	98.1 ± 2.8	98.8 ± 1.3	0.531	98.3 ± 2.0	100 ± 0.0	0.102
DPS (%) average ± SD	42.9 ± 19.1	62.0 ± 16.9	0.005	47.8 ± 23.3	55.3 ± 22.2	0.449	48.3 ± 29.8	70.4 ± 11.3	0.136
MLD (dB) average ± SD	8.9 ± 4.2	11.4 ± 1.4	0.033	9.3 ± 3.2	11.6 ± 1.3	0.041^a a p ≤ 0.05 (level of statistical significance).	10.0 ± 2.8	11.4 ± 1.5	0.270
RGDT (ms) average ± SD	16.0 ± 7.0	3.9 ± 1.6	<0.001	12.4 ± 3.3	4.6 ± 2.1	<0.001^a a p ≤ 0.05 (level of statistical significance).	12.8 ± 8.8	3.6 ± 0.61	0.050^a a p ≤ 0.05 (level of statistical significance).

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[1] * Corresponding author. E-mail: marciasm@ufcspa.edu.br (M.S. Machado).