Prevalence of otitis media with effusion in children with bilateral sensorineural hearing loss

Article Abstract:

Otitis media with effusion (inflammation and an accumulation of fluid, often pus, within the middle ear) is a common childhood ailment. Despite extensive study, the mechanisms underlying the development of otitis media are unclear. Negative middle ear pressure and abnormal function of the eustachian tube (which extends between the middle ear and the pharynx or throat) have been implicated. The incidence of otitis media was studied among children with sensorineural hearing loss media who were born between 1981 and 1984 in Manchester, England. Significant bilateral sensorineural hearing loss (caused by abnormal function of nervous system-related hearing structures) was diagnosed in 164 children, indicating a prevalence of 1 affected child per 817 births. The causes of sensorineural hearing loss were divided into groups, such as German measles, cytomegalovirus, perinatal factors, meningitis, and genetic and chromosomal abnormalities. Otitis media with effusion prevents the conduction of sound and, consequently, causes conductive hearing loss. This problem occurred in 57 percent of the children with sensorineural hearing loss; 24 percent of these patients required surgical treatment. The results suggest that children who have sensorineural hearing loss, due to congenital infections, adverse perinatal factors, and chromosomal abnormalities, tend to develop otitis media with effusion and conductive hearing loss more often than other groups of children. However, there were too few subjects to determine whether or not this difference is significant. The mechanisms by which these perinatal and congenital conditions may be associated with otitis media are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Demographic aspects, Otitis media, Hearing disorders in children, Childhood hearing disorders

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Rehabilitation of head injured children

Article Abstract:

In Britain, as in many developed countries, the greatest cause of death of children between 1 and 14 years of age is accidents. Forty percent of these accidents involve head injury. For those who do not die, head injury becomes a devastating event for both patient and family. The rehabilitation of the head injured patient involves the cooperation of many different professionals. Therapists provide training for motor tasks; the results of this training must be carefully monitored by the neurologist. Furthermore, the neurologist must monitor signs of neurological damage, as well as treat complications, such as seizures. Many cases involve cognitive and emotional deficits as well, and a skilled staff is required to recognize that apparent reduction in global intelligence may actually mask a variety of more specific problems. The quality of life that can be experienced by the head-injured child is dependent upon the mobility which can be achieved and the communication which can be maintained. It is especially important to be aware of the potential for communication among patients who might seem to be vegetative. Very often, only slight changes in facial expression provide the clue that the patient understands speech and would like to communicate. Another important aspect of the child's life is education, although several problems may make a return to school difficult. In addition to the obvious problem of brain damage, there is the related problem which stems from the often normal appearance of head-injured children. Teachers may be unsympathetic or impatient with cognitive or emotional problems in a child who does not appear to be impaired. (Consumer Summary produced by Reliance Medical Information, Inc.)

Head injuries, Brain-damaged children

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Paradoxical approach to the management of faecal incontinence in normal children

Article Abstract:

Fecal incontinence is described as the inability to retain feces and is usually due to the loss of muscle control or brain and spinal cord damage. When it occurs in children, this condition is very distressing to the family. Fecal incontinence affects about 1.5 percent of children aged seven to eight years. Family distress is often worsened because the child may claim that nothing has happened and may be perceived as not caring about the incontinence. Treatments such as behavioral therapy, psychoanalytical therapy, surgery, dietary therapy, and electrostimulation have been tried with little success. A single, effective treatment for fecal incontinence in children has not been described. The behavior is thought to persist because it is a way for the child to control his/her parents; the subsequent attention only reinforces the behavior. A new paradoxical approach recently put forward for the treatment of fecal incontinence is based on making the child think about their bowel actions and how they affect other people. The child is encouraged by the physician to continue soiling his/her clothes because that is the way the child expresses his/her emotions, and the child is praised when soiling occurs. It is thought that the child will eventually become angry with the physician and voluntarily stop soiling. It is suggested that this method of treating fecal incontinence may work when conventional treatments do not. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Social aspects, Fecal incontinence, Pediatric gastroenterology, Fecal incontinence in children

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