In the present study, pure-tone audiometry was used in 687 Finnish school children, aged 6-15 years, to determine the prevalence of a 6 kHz acoustic dip and related factors among three age groups. Trained audiometricians tested air conduction thresholds in a sound-proof room. A total of 57 children (8.3%) had a clear-cut dip of at least 20 dB at 6 kHz. This dip was more pronounced in older children and in boys. A thorough case history was obtained by questionnaire, with logistic regression analysis showing that low birth weight (
The Rinne and the Weber tests were carried out using a 256-Hz tuning fork on 687 6- to 15-year-old school children, the majority of whom were normally hearing subjects. The Rinne test was positive in 97% of ears with normal hearing or sensorineural hearing loss and negative in 72% of ears with conductive hearing loss. The Rinne test changed from positive to negative at 13 dB when performed using the normal loudness comparison method. In midline Weber results, the mean value of the air conduction difference at 0.25 kHz between the right and left ear was 1.4 dB. The lateralization in the Weber test occurred at a difference of 2.5 dB between the right and left ear. The Weber test was in midline in 96-98% of ears with bilateral normal hearing or sensorineural hearing loss. It lateralized to the poorer ear in 63% of ears with unilateral conductive hearing loss. The values of the Rinne and Weber tests were not good in the diagnosis of mild conductive hearing loss when the air-bone gap was 5-35 dB.
A total of 663 unselected 7-, 10- and 14-year-old school children were examined for both ultrasound and X-ray maxillary sinus findings. Ultrasound and X-ray findings were normal in 84.5% and 83.9% of the children, respectively. In a comparison of the findings, the sensitivity of ultrasound examination compared to abnormal maxillary sinus X-ray findings was low. However, a negative ultrasound finding was a sound basis for excluding the disease. According to the results of the present study, it is perhaps justified to say that a negative ultrasound finding excludes the occurrence of radiographic sinusitis, whereas a positive ultrasound finding has little or minor significance.
A total of 687 school children, aged 6-15 years, were examined for nasal septal deviations with anterior rhinoscopy and maxillary sinus radiography. Septum deviations were divided into four different categories and the final evaluation included the clinically significant deviation, based on purely morphological findings. Columella deviation was an exceptional condition in 0.7% of children, septum spurs were found in 3.8%, bending of the quadrilateral cartilage was present in 13.4%, and premaxillary luxation in 28.7%. A clinical diagnosis of septum deviation was made in 9.5% of children. The occipitomental projection of the maxillary sinus X-ray was a good diagnostic tool in evaluating the clinical significance of septum deviation.
Pure-tone audiometric and impedance examinations were performed in 687 Finnish school children in the first, fourth and eighth grades (ages, 7, 10 and 14 years old) to study the sensitivity and usability of hearing and tympanometric screening examinations in schools. There were 138 children (20.1%) with a hearing loss > 15 dB in at least one frequency. Among these children, 103 were found to have pure sensorineural losses while 35 children had conductive losses. Of all the sensorineural losses, 118 of the cases involved slight high-frequency changes. Six children had hearing losses at speech range and all had been previously diagnosed. Six other children had 20-30 dB losses at 3-6 kHz, with 5 of these children diagnosed for the first time. Twenty-four of the children with conductive losses had middle ear effusions that were found at a 15 dB screening level for hearing. When the limit of normal tympanometric peak pressure was-150 daPa, 36 of 38 ears with middle ear effusions were found tympanometrically. Judging by the findings of the present study, we recommend that routine pure-tone audiometric screening for 7- and 10-year-old children in schools could be discontinued but should be continued for 14-year-old children. In contrast, tympanometry with a tympanometric peak pressure limit at-150 daPa should be used as a screening procedure for 7-year-old children on school entry.