Children's Health

Otitis media may not substantially increase risk of delayed speech development in typically developing children

Half of children who suffer an episode of otitis media with effusion (OME, fluid in the middle ear without evidence of ear infection) suffer a mild hearing loss, while about 5 to 10 percent suffer moderate hearing loss. However, for typically developing children, OME may not be a substantial risk factor for delayed speech and language development or poorer academic achievement.

One of the major reasons for medical management of OME, including use of antibiotics and tympanostomy tubes, is to prevent potential developmental consequences associated with hearing loss. However, recently published studies suggest that parenting is a much more powerful force than antibiotics and surgery in promoting language development among children with histories of OME. These are the major conclusions of a recent review of research on the topic. The review, led by Joanne Roberts, Ph.D., of the University of North Carolina, Chapel Hill, was supported in part by the Agency for Healthcare Research and Quality (HS12072).

The researchers found that, although median hearing loss in children with OME is relatively mild, there is a wide range of hearing loss associated with OME. Data are insufficient to conclude or refute a potential linkage between OME and central auditory processing. Antibiotic therapy increases short-term OME resolution by 15 percent, but it has minimal utility because of frequent relapse. Antihistamines, decongestants, and corticosteroids are ineffective. In contrast, tympanostomy tubes reduce OME prevalence by 115 days per child-year, which represents a 67 percent relative risk reduction. Adenoidectomy reduces OME prevalence by 38 percent in children with prior tube placement, and it reduces the need for tube reinsertion by about 50 percent when performed concurrent with initial tube placement. Tympanostomy tubes significantly improve hearing on a short-term basis, but in the long term, hearing levels are equal in untreated and treated ears.

See "Otitis media, hearing loss, and language learning: Controversies and current research," by Dr. Roberts, Lisa Hunter, Ph.D., Judith Gravel, Ph.D., and others, in the April 2004 Developmental and Behavioral Pediatrics 25(2), pp. 110-122.

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