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Do the size, site and activity of tympanic membrane perforations relate to hearing loss in Aboriginal and Torres Strait Islander children? An observational study.
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  • Jack Morris,
  • Zoe Lee,
  • Andrew Carney,
  • Linnett Sanchez
Jack Morris
Flinders University
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Zoe Lee
Flinders University
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Andrew Carney
Flinders University
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Linnett Sanchez
Flinders University
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Abstract

Objective: To investigate the effect of size, site and activity of tympanic membrane (TM) perforation on hearing loss (HL) in Aboriginal and Torres Strait Islander (ATSI) children. Design: Observational study Methodology: Children aged 5-18 years who identified as ATSI at 7 Anangu community schools within the APY Lands and Maralinga Lands of South Australia underwent 4 frequency pure-tone audiometry (0.5, 1, 2 and 4kHz) and video-otoscopy (VO). VO data was reviewed by surgeons for a middle ear diagnosis and VO files with TM perforations were then classified by perforation site (AS, AI, PS, PI, A, P, I) and size (<25%, 25–50%, 50–75% or 75–100%). Results: 575 VO files with matching audiological data were obtained. Active perforations (35dBHL; 28-44 IQR) demonstrated greater HL than inactive perforations (31dBHL; 29-39 IQR) p=0.0029. For inactive perforations there was a significant difference between <25% and all larger perforations (p<0.0001) whereas for active perforations the significance changed to between <25% (p<0.0001) and 25-50% (p<0.05) when compared to larger perforations. When perforation site was compared within all size/activity groups, no statistically different findings were identified. In all analyses findings did not change when individual frequencies were compared to 4-frequency pure tone average dBHL. Conclusion: In ATSI children from remote communities HL is greater in ears with larger perforations and active middle ear disease but there was no relationship between perforation site and HL.