Ear diseases pattern and hearing assessment in the rural community By manual audiometry

Objective: The aim of the present study and work is to determine the ear diseases pattern, etiological factor, type and severity of hearing loss in rural community by manual pure tone audiometry. We have also made efforts for the early detection and treatment of hearing loss by surgical correction, rehabilitation and referred to higher center for cochlear implantation. Introduction: More than 360 million people have disabling hearing loss in worldwide and its 5.3% of the world population. More than 63 million people are suffering from auditory impairment in India as per WHO. This is an estimated prevalence of 6.3% in Indian population. India is a developing country. It is ridden with illiteracy, poverty and sociopolitical problem. Chronic suppurative otitis media (CSOM) is one of the most common ear diseases in South East Asia having a prevalence of 5.2% in the general population but in India is 4.75%. Chronic Suppurative Otitis Media (CSOM) is one of the most common childhood infectious diseases worldwide. It is most common causes of hearing impairment. It is estimated that there are 31 million new cases of CSOM per year in worldwide. Hearing is essential for the development of language, speech and cognitive skills. The neurological development of hearing abilities requires an acoustic stimulation in the first two year of life. The different methods are available for assessment of hearing loss in different age group likes behavioral observation audiometry (BOA), conditioning techniques, pure tone audiometry (PTA), speech audiometry, impedance audiometry, otoacoustic emissions (OAE) and brainstem evoked response audiometry (BERA)/ auditory brainstem response(ABR). Material and Methods: The prospective study was conducted from January 2011 to January 2012, which included 1144 patients in Gold fields Institute of Medical Sciences, Faridabad, Haryana. Those patients who were presenting with diminished hearing loss and ear symptoms were enrolled in study. The complete Clinical examination, Otoscopic, tuning forks test, and radiological evaluation were done in all patients. Hearing assessments were done by manual pure tone audiometry for all patients. Those patients who suffered from wax, otomycosis, furnculosis,suspicious malignancy of external and middle ear are excluded from study. All patients were managed by medical, surgical, suction and cleaning, reassurances and referred to cochlear implanted center. Nature and prevention of ear diseases were explained to all patients in rural community. Results: All patients (1144) had ear diseases and 68 (5.94%) patients were found having normal hearing. Male (719) patients suffered more hearing loss than female patients (425) 62.85% and 37.15%respectively. Ear diseases and hearing loss involved commonly in bilateral ear (53.49%). The youngest group consisted two hundred ninety eight patients (26%) between twenty one to thirty years of age. Interventions: A total 1144 patients between the age of 6 years to 94 years were self reported hearing difficulty assess by manual pure tone audiometer (arphi model ). Hearing assessment measured by Audiometer in different frequency at 250, 500, 1000, 2000, 4000, and 8000Hz. Conclusion: Our study revealed that 94% patients had hearing impairment of self reported hearing loss. Conductive type of hearing loss is the most common type of hearing impairment in rural community and it’s about 64% (736) which is treatable if the pattern of diseases and degree of hearing loss is evaluated early. Chronic Otitis Media is the most common cause of hearing impairment. Conductive type of hearing loss is the most common type of hearing impairment and it’s about 64% (736).Chronic Otitis Media (more than 57%) is one of the most common disease found in our study.