The Impact of Early Childhood Otitis Media on Hearing Abilities: A Scoping Review.

Abstract

Objectives: Otitis media (OM) is among the most common childhood diseases. Many studies have suggested that recurrent OM episodes during early childhood can have long-lasting adverse effects on essentially every level of the auditory system. However, the literature on this topic is heterogeneous and results are mixed. Hence, a need exists to structure the available evidence. Here, a scoping review was conducted, aiming to (1) map the many different outcome measures used to assess the long-term impact of OM, (2) appraise the quality of the available OM documentation, and (3) provide a summary of the available evidence and its potential link with OM documentation.

Design: Original articles were identified through systematic searches in the PubMed, Embase, and Cochrane Library databases. To be included, studies were required to assess the long-term impact of resolved early childhood OM on hearing abilities. Two reviewers independently screened studies for inclusion. A data charting form, developed by author LVY, was used to extract information about the publication (year, journal, country of data collection) and study characteristics (sample size, outcome measures, OM documentation).

Results: The search identified 16,267 records, out of which 94 articles were included. Most of the current evidence is based on retrospective data from high-income countries, using a wide range of outcome measures. The retrospective study design poses challenges for thorough OM documentation, especially regarding OM history of the controls. A narrative synthesis showed consistently elevated audiometric thresholds in the extended high-frequency range and poorer gap detection abilities in children with a history of early childhood OM. Mixed results were found in terms of speech perception and binaural unmasking.

Conclusions: This scoping review demonstrates the breadth of the literature on this topic. A wide range of outcome measures have been used, and the quality of OM documentation varies greatly across studies. Variability of the literature results may-at least to some extent-be explained by inadequate OM documentation, recruitment bias, and variability in the time since the last OM episode. Recommendations for future research are provided.