The effect of saccular function on static balance ability of profound hearing-impaired children

Objective

Researches have shown that in clinical practice, balance disorders in children with congenital or early acquired severe to profound hearing loss are probable. The purposes of present study were to specify the percentage of vestibular evoked myogenic potential (VEMP) and an acoustically evoked, short latency negative response (ASNR) recordings and the relation between their presence and static balance ability and postural control of children with profound sensorineural hearing loss (SNHL).

Methods

Thirty children with profound SNHL, with an average age of 6.93 years, underwent the VEMP and auditory brainstem response (ABR) tests. Both VEMP and ABR were recorded at the threshold level through air-conduction stimulation via an insert receiver. The static balance performance of the hearing-impaired children was tested with six exercises and compared with that of 30 age- and sex-matched normal-hearing children as controls.

Results

VEMP was recorded in 53.3% of ears and ASNR in 40.0%. VEMP was revealed in all ears with ASNR, and a significant correlation was shown between their presence (p = 0.005) and also between the ASNR wave latency and P1 (p = 0.0001) and N1 (p = 0.004) wave amplitude of VEMP. There was a significant correlation between the presence of VEMP and ASNR with the performance of the children in two static balance skills, namely standing on one leg with eyes open on a line and the same practice on the balance beam (p ≤ 0.008).

Conclusion

There was a close relation between the presence of VEMP and ASNR. Additionally, when ASNR was present, the recording of VEMP could be expected. Successful performance in the static balance exercises with reduced vestibular and somatosensory inputs increased the possibility of the recording of ASNR and VEMP.     

The effect of mild hearing loss on academic performance in primary school children

Objectives

To determine the prevalence of mild hearing loss and its association with academic performance among primary school children.

Patients and methods

A comparative cross sectional study was conducted on standard (grade) five school children in a state in Malaysia. Five schools were selected by using simple random sampling. There were three classes (A, B and C) of standard five in each school. Student's selection into these classes was made by respective school administration based on their final term examination in standard four. Class A was for the best academic achievers while class C was for the poorest. Ear examinations were done followed by pure tone audiometry for confirmation of the hearing status. In this study, mild hearing loss was defined as an average threshold of 20-39 dB at 0.5, 1, 2 and 4 kHz. Data analysis was done using SPSS Version 12.0 software. Chi-square test was used to determine the association between mild hearing loss and academic performance. The significant level was set at p = 0.05.

Results

From a total of 257 students, 234 have completed the examinations (response rate = 91.0%). Fifty-three percent of them were boys while 47% were girls. A hundred and forty-nine (63.7%) of them were from class A while 85 (36.3%) were from class C. The prevalence of hearing loss in our school population was 15% (95% CI: 11.0-20.0%). Thirty-two (88.9%) of them were having conductive type. Out of the total, 38.9% were having problems in both ears. The students who have poor academic performance have been shown to be significantly associated with mild hearing loss (p < 0.001).

Conclusions

There was a high prevalence of mild hearing loss among primary school children. This problem could affect their academic performance. Therefore, hearing assessment is highly recommended to be done on every child especially to those who have poor academic achievement.     

Newborn hearing screening on infants at risk

Objectives

This article presents the results of newborn hearing screenings on infants at risk of hearing impairment at the French University Hospital of Besançon from 2001 to 2007.

Materials and methods

All newborns at risk of hearing impairment were tested according to the method recommended by the Joint Committee on Infant Hearing (JCIH): a two-step automated oto-acoustic emissions (AOAE) program, completed by an auditory brainstem response (ABR) for the positive diagnosis of hearing impairment. The screening started with AOAE on the third day of life, at the earliest. If one or both ears did not have AOAE, the infant was re-tested at which time, should the AOAE again be positive, ABR was performed. When the ABR threshold was 40 dB or more, the infant was referred to an audiologist specialized in infant deafness for diagnosis confirmation and management.

Results

Over the period, 1461 infants were screened, among whom 4.55% were diagnosed as deaf or hard of hearing. Nearly 10% of the infants were lost to follow up. Forty-six children had a sensorineural hearing impairment, of which 34 were bilateral and were managed before the age of 6 months. The risk factors for sensorineural hearing loss were (in order of statistical significance): severe birth asphyxia; neurological disorder; syndromes known to be associated with hearing loss; TORCH (toxoplasmosis, rubella, cytomegalovirus, herpes) infections; family history of deafness; age at the time of screening; and the association of 2 or more risk factors. However, birth weight inferior to 1500 g and premature birth before the 34th week of pregnancy did not show a statistically significant influence on sensorineural hearing loss. Craniofacial anomalies (mostly cleft palate and ear aplasia) were a significant factor for conductive hearing loss.

Conclusion

Our selected hearing screening on infants at risk allowed 60 deaf children access to early management. However, too many children were lost to follow up; which revealed that better information regarding risk of hearing loss must be provided to parents and paramedics and universal newborn screening needs to be performed. The most important result of this study is that in a population of hearing impaired children, with an impairment incidence close to what is commonly reported, the association of several risk factors proves to be a significant additional risk factor for hearing impairment.     

A comparison of the speech recognition and pitch ranking abilities of children using a unilateral cochlear implant, bimodal stimulation or bilateral hearing aids

Objective

The present study compared the speech recognition and pitch ranking abilities of normally hearing children (n = 15) to children using a cochlear implant (CI) alone (n = 8), bilateral hearing aids (HAs) (n = 6), or bimodal stimulation (BMS) (n = 9). It was hypothesised that users of BMS would score higher on tasks of speech and pitch perception than children using a CI alone, but not children using HAs.

Methods

Participants were assessed on tasks of monosyllabic word recognition in quiet, sentence recognition in quiet and noise (10 dB signal-to-noise ratio), and a pitch ranking task using pairs of sung vowels one, half, and a quarter of an octave apart.

Results

There were no significant differences between the mean percentage-correct scores of the four participant groups for either words in quiet or sentences in quiet and noise. However, the proportion of bimodal users who scored >80% correct (80%) was significantly greater than the proportion of high-scoring unilateral CI (25%) or bilateral HA users (17%). Contrary to expectations, there was also no significant difference between the pitch ranking scores of users of BMS and users of a CI alone for all three interval sizes (p < 0.05, RM-ANOVA). However participants using only acoustic hearing (i.e. the NH and HA groups) scored significantly higher than participants using electrical stimulation (i.e. the CI and BMS groups) on the pitch ranking task (p < 0.05; RM-ANOVA).

Conclusions

Contrary to findings in postlingually deafened adults, we found no significant bimodal advantage for pitch perception in prelingually deafened children. However, the performance of children using electrical stimulation was significantly poorer than children using only acoustic stimulation. Further research is required to investigate the contribution of the non-implanted ears of users of BMS to pitch perception, and the effect of hearing loss on the development of pitch perception in children.     

Investigating child raising attitudes of fathers having or not having a child with hearing loss

Aim

The main goal of this study is investigating child raising attitudes of fathers having or not having a child with hearing loss.

Material and method

The fathers of 20 children with hearing loss who attend the Training Unit of Hearing and Speaking Abilities in Hacettepe University Department of Audiology and Speech Defects and 20 fathers having children who have a normal hearing have participated in this study. Demographic Information Form and P.A.R.I (Parental Attitude Research Instrument) have been used as devices for data collecting.

Results

Sub dimension of overprotection scores (42.76 ± 5.59) of the fathers having a child with hearing loss are found higher on a statistically meaningful level than the scores (40.16 ± 6.55) of fathers who do not have a handicapped child (p < 0.01). Together with this, the fathers having a child with hearing loss get lower scores from the democratic/equality and strict discipline sub dimensions as compared to the fathers who do not have a handicapped child, and this situation is found meaningful statistically (p < 0.01).

Conclusion

It is very important that the father's having enough information and support help the father to be encouraged and feel himself enough for this issue. Moreover, the wrong attitudes and behaviors towards the child can be corrected upon noticing them.     

Development of canal cholesteatoma in a patient with prenatal isotretinoin exposure

Purpose

To describe the clinical and radiologic findings in a case of isotretinoin embryopathy-like syndrome and discuss management of hearing loss, congenital external auditory canal (EAC) stenosis, and EAC cholesteatoma.

Methods

Review of medical, audiological, and radiological records.

Results

An 8 year old female presented with bilateral moderate conductive hearing loss, bilateral microtia, left EAC stenosis, and right EAC atresia, secondary to prenatal isotretinoin exposure. Comorbidities included developmental delay, ventricular septal defect, hypotonia, and retinal maldevelopment. The left EAC was sharply upsloping with a 2 mm-diameter meatus. Computed tomography (CT) scan of the temporal bone demonstrated normal middle and inner ears bilaterally; serial CT scans over 6 years demonstrated progressive development of left canal cholesteatoma. Implantation of a right BAHA system was performed, followed by left canalplasty and excision of cholesteatoma with facial nerve monitoring. An endaural incision was utilized to avoid compromising future microtia repair. Postoperative left-sided hearing improved to mild low-frequency conductive hearing loss rising to normal at 2000 Hz and above.

Conclusions

Despite extensive precautions for its use, isotretinoin remains a cause of major birth defects, including sensorineural, conductive or mixed hearing loss. Congenital EAC stenosis is much less common than congenital atresia or acquired stenosis; optimal surgical approaches vary depending on hearing status and facial nerve anatomy. Close monitoring for development of canal cholesteatoma is necessary.     

Sensorineural hearing loss in pediatric celiac patients

Objective

Celiac disease (CD) is an immune-mediated chronic inflammatory gluten-dependent intestinal disease affecting 0.5-1% of the general population worldwide. CD is underdiagnosed even with sophisticated health care; approximately 10% of people affected by CD are now diagnosed. The recognition of the atypical extra-intestinal manifestations, including neurological disorders increased the diagnosis of CD. At present, no data are available on the presence of sensorineural hearing loss in pediatric CD patients. The aim of this study was to determine the incidence and severity of sensorineural hearing loss (SNHL) in different frequencies in pediatric CD patients.

Methods

A sample of 32 biopsies and serologically proven newly diagnosed pediatric CD patients (CD group) (64 ears) and 32 sex and age-matched healthy subjects (64 ears) as control group (C group) were included in this study. Anthropometric measurements, physical examinations including ear nose and throat and pure-tone audiometry at frequencies 250-8000 Hz were performed in all subjects in both groups. Slight/mild SNHL was defined as a loss of detection of sound within the 16-40 dB range. The mean age of patient and control group was 11.9 and 11.3, respectively (p > 0.05).

Results

In CD group, sensorineural hearing loss was found in 13 (40.6%) patients (group A) as it was bilateral in six and unilateral in seven patients. In control group (group C), slight/mild SNHL was found in one (3.1%) subject. The frequency of hearing loss was significantly higher in CD group than in group C (p < 0.001).

Conclusion

The present study showed a higher prevalence of sensory neural hearing loss in pediatric celiac patients than in healthy controls, suggesting an association between CD and SNHL. The findings of this study suggest that hearing impairment should be searched in newly diagnosed pediatric CD patients. Further longitudinal investigations on a larger sample size will be necessary to confirm the present data and to search the immunological processes which could be the basis of the association between CD and SNHL.     

Progressive hearing loss after completion of cisplatin chemotherapy is common and more pronounced in children without spontaneous otoacoustic emissions before chemotherapy

Objective

High frequency hearing loss following cisplatin chemotherapy is frequent in children and often necessitates the fitting of hearing aids. During therapy, hearing is usually monitored. Post-therapeutic follow-up does not routinely include monitoring of hearing, although there are indications that hearing thresholds can decline after therapy.

Methods

Pure-tone audiograms taken from 27 children (17 males, 10 females) treated with cisplatin at Muenster university hospital (mean age 9.84 years, standard deviation 3.67 years) including an audiological follow-up at least 6 months after therapy, were analyzed retrospectively.

Results

In follow-up tests after completion of therapy, 24.1% of all ears showed an increase in mean high frequency hearing thresholds (4-8 kHz). Post-therapeutic hearing deterioration was significant at 4 kHz and significantly more pronounced in children without measurable spontaneous otoacoustic emissions (SOAE) before therapy. Post-therapeutic hearing deterioration did not occur in ears with normal pure tone thresholds (≤10 dB at all frequencies) after cisplatin therapy. No correlation was found between post-therapeutic hearing deterioration and cranial irradiation.

Conclusions

Cisplatin chemotherapy follow-up should include audiological monitoring in all children with elevated pure tone thresholds after therapy. Routine SOAE measurements taken as part of baseline audiometry before the start of chemotherapy can be taken into consideration.     

Characteristics of hearing impairment in Yemeni children with chronic suppurative otitis media: A case-control study

Background

Chronic suppurative otitis media (CSOM) is a serious disorder particularly in low resource settings. It can lead to disabling hearing impairment and sometimes life-threatening infective complications.

Objective

The aim of the present study was to describe the characteristics of hearing impairment associated with CSOM in Yemeni children.

Methods

A case-control study of 75 children with CSOM and 74 healthy controls. Hearing was assessed by behavioural testing and audiometry.

Results

Cases had lower academic performance than controls (OR 15.31, 95% CI 1.99-322.14, p < 0.001). Disabling hearing impairment >30 dB was present in 51.5% (right ear) and 66.7% (left ear) of children with CSOM.

Conclusion

Disabling hearing impairment was identified as a major health problem in these Yemeni children with CSOM. There is a need for investment to reduce the burden of CSOM and its complications in these communities. Greater attention to the chronic disabling effects of CSOM in children is required in poor communities and low resource settings.     

Parent versus child assessment of quality of life in children using cochlear implants

Objective

Children with hearing loss who use cochlear implants have lower quality of life (QoL) in social situations and lower self-esteem than hearing peers. The child's QoL has been assessed primarily by asking the parent rather than asking the child. This poses a problem because parents have difficulty judging less observable aspects like self-esteem and socio-emotional functioning, the domains most affected by hearing loss.

Methods

This case-control study evaluated QoL in 50 preschoolers using a cochlear implant and their parents with the Kiddy KINDL^®, an established QoL measure. Children's responses were compared to a hearing control group and correlated with demographic variables. We used a questionnaire for parents and a face-to-face interview with children. T-tests were used to compare (a) paired parent-child ratings and (b) children with cochlear implants versus normal hearing. Pearson rank correlations were used to compare QoL with demographic variables.

Results

Children using cochlear implants rated overall QoL significantly more positively than their parents (M_Difference = 4.22, p = .03). Child rating of QoL did not differ significantly by auditory status (cochlear implant (82.8) vs. hearing (80.8), p = .42). Overall QoL correlated inversely with cochlear implant experience and chronologic age, but did not correlate with implantation age.

Conclusions

Preschool children using cochlear implants can assess adequately their own QoL, but parents afford valuable complementary perspective on the child's socio-emotional and physical well-being. Preschool children using cochlear implants rate overall QoL measures similar to hearing peers. A constellation of QoL measures should be collected to yield a better understanding of general QoL as well as specific domains centered on hearing loss.     

Neonatal hearing screening in Benin City

Objective

Congenital hearing loss is a major health care problem that tends to retard the developmental milestones of children. It takes early detection and intervention to avoid a permanent loss in acquisition of speech and cognitive functions. Hence, the importance of hearing screening in all newborns especially in the developing world for accurate statistics and early intervention. Therefore, this work was aimed at detecting the crude prevalence of congenital hearing loss among the newborns in Benin City.

Methodology

Consecutive neonates at designated immunization centers in Benin City metropolis were screened for hearing loss via the detection and analysis of distortion product otoacoustic emissions from both ears. The handheld otoacoustic machine model MAICO 8172 was employed and the outcome results presented in tables. Statistical analysis was performed using SPSS 11.

Results

A total of 400 neonates (218 males and 182 females) were screened for the presence of otoacoustic emission in both ears. Ninety neonates (22.5%) p < 0.05 were referred. Bilateral hearing loss was seen in 26 (6.5%) whereas 64 (16%) had unilateral loss.

Conclusions

The screening tests suggest a high crude prevalence (6.5%) of bilateral neonatal hearing impairment in Benin City necessitating confirmation and intervention. The study fortifies the need for hearing screening among all new born in developing countries.     

Screening for delayed-onset hearing loss in preschool children who previously passed the newborn hearing screening

Objective

The goal of this study was to investigate the prevalence of delayed-onset hearing loss in preschool children who previously passed newborn hearing screening in Shanghai, China.

Methods

Between October 2009 and September 2010, 21,427 preschool children were enrolled from five areas of Shanghai, who had passed newborn hearing screening. Children were screened for delayed-onset hearing loss with pediatric audiometers. Children with positive results in initial and re-screening tests were assessed audiologically and for risk indicators according to the Year 2007 Statement of the American Joint Committee on Infant Hearing (JCIH).

Results

During the study period, 445 children (2.08%) were referred for audiologic assessment; 16 (0.75/1000, 95% CI 0.38-1.12) had permanent delayed-onset hearing loss. Of these, five (0.23/1000) had bilateral moderate hearing loss; seven (0.33/1000) had mild bilateral hearing loss; and four (0.19/1000) had unilateral moderate or mild hearing loss. JCIH risk indicators were established for six children (6/16, 37.5%), including parental concern regarding speech and language developmental delay, neonatal intensive care unit with assisted ventilation or hyperbilirubinemia, recurrent otitis media with effusion, craniofacial malformation, and family history (n = 1 for each). The remaining ten (62.5%) had no related risk factors.

Conclusions

A significant proportion of preschool children have undiagnosed delayed-onset hearing loss. Hearing screening in preschool is recommended for an early detection.     

Tone burst stimulus for auditory brainstem responses: Prediction of hearing threshold at 1 kHz

Objective

To assess differences in hearing threshold estimation of four different ABR tone-bursts at 1 kHz.

Methods

Twenty-one (21) ears from 11 subjects were tested with pure-tone audiometry (PTA): 5 ears (24%) were normal hearing, 5 (24%) affected by mild hearing loss, 7 (33%) showed moderate hearing loss and 4 (19%) severe hearing loss. After PTA each subject underwent tone-burst ABR test at 1 kHz using a linear gated (L_ABR) or Blackman windowed (B_ABR) stimuli with (nn_ABR) and without ipsilateral notched noise. Stimulation rate and filters settings were unchanged.

Results

Overall correlation between PTA and all ABRs thresholds was high, ranging from 0.84 to 0.94. In normal hearing ears none of the differences was significant, except for those measured with B_nn_ABR, which showed a mean 16 dB overestimation of the pure-tone threshold (p < 0.05). In mild hearing loss group none of the differences between thresholds were significant. In moderate and severe hearing loss groups significant differences were measured with L_nn_ABR (p < 0.05) with a mean 7.5 dB underestimation of PTA.

Conclusions

Although very similar, some significant differences were found when considering specific group of patients with different degrees of hearing loss.     

Risk factors for sensorineural hearing loss in NICU infants compared to normal hearing NICU controls

Objectives

To evaluate independent etiologic factors associated with sensorineural hearing loss in infants who have been admitted to the neonatal intensive care unit compared to normal hearing controls.

Method

Between 2004 and 2009, 3366 infants were admitted to the neonatal intensive care unit of Sophia Children's Hospital, of which 3316 were screened with AABR. A total of 103 infants were referred for auditory brainstem response analysis after failure on neonatal hearing screening. We included all infants diagnosed with sensorineural hearing loss. Each patient was matched with two normal hearing controls from the neonatal intensive care unit of the same gender and postconceptional age.The following risk factors were studied: birth weight, dysmorphic features, APGAR scores (at 1, 5 and 10 min), respiratory distress (IRDS), CMV infection, sepsis, meningitis, cerebral bleeding, cerebral infarction, hyperbilirubinemia requiring phototherapy, peak total bilirubin level, furosemide, dexamethason, vancomycin, gentamycin and tobramycin administration.

Results

Fifty-eight infants were diagnosed with sensorineural hearing loss: 26 girls and 32 boys. The incidence of dysmorphic features (P = 0.000), low APGAR score (1 min) (P = 0.01), sepsis (P = 0.003), meningitis (P = 0.013), cerebral bleeding (P = 0.016) and cerebral infarction (P = 0.000) were significantly increased in infants with sensorineural hearing loss compared to normal hearing controls (n = 116).

Conclusion

Dysmorphic features, low APGAR scores at 1 min, sepsis, meningitis, cerebral bleeding and cerebral infarction are associated with sensorineural hearing loss independent of neonatal intensive care unit admittance.     

The role of audiological diagnostics in children with cleft lip & palate (CLP)

Objective

To assess the otologic and audiologic status of patients with cleft lip and palate (CLP) operated in the Department of Pediatric Surgery attached to the Advanced Pediatric Centre, Post Graduate Institute of Medical Education & Research (PGIMER), India. The main idea of carrying out this study was to know the incidence of middle ear pathologies in a group where no complaints have been noticed.

Setting

Research study was carried in Post Graduate Institute of Medical Education & Research (PGIMER) which is one of the tertiary care institutions in India.

Participants

55 children (Mch: 28; Fch: 27) in the age range of 4-13 years constituted the study group. These children were operated upon by the same surgeon (JKM) during the period 1996-1998 and were attending the speech clinics at PGIMER. None of these children/parents had complained of any ear problem and were taken up for the study to find out the middle ear pathology. The ontological and audiological evaluation was done for all the children.

Results

53 of 110 ears had normal hearing status. None of the ears had severe or profound hearing loss. The air conduction thresholds ranged from 20.2 to 29.63 dB across the frequencies whereas the bone conduction thresholds varied from 7.13 to 12.41 dB. Only 42% of the right (R) ears and 47% of the left (L) ears had a normal tympanic membrane.

Conclusion

On the basis of this finding, investigation of the benefits of early and routine follow-up for otologic and audiologic status is warranted. Patients with cleft lip and palate should have an intense and detailed otologic and audiologic follow-up to identify any ME pathology/hearing loss so that timely intervention can be taken.     

Evaluation of cochlear involvement by transient evoked otoacoustic emission test in children with Crimean-Congo hemorrhagic fever

Objective

The aim of this study was to investigate cochlear involvement in child patients with Crimean-Congo hemorrhagic fever (CCHF) disease.

Methods

Twenty-eight CCHF disease patients (56 ears) and 26 sex- and age-matched healthy control subjects (52 ears) were included in the study. Pure-tone audiometry at frequencies 0.25, 0.5, 1, 2, 4, and 6 kHz, immittance measures including tympanometry and acoustic reflex testing, and transient evoked otoacoustic emission (TEOAE) testing were performed in the patients and controls.

Results

The proportion with a result of ‘fail’ for the TEOAE test in the CCHF patients was not statistically significant from the control group (p > 0.05).

Conclusions

CCHF disease does not impair cochlear function in children. The clinical course of CCHF among children seems to be milder than in adults.     

Appropriate hearing screening in the pediatric patient with head trauma

Purpose

To develop an algorithm for the appropriate audiologic screening of in children with head trauma.

Methods

Participants were the first consecutive 50 children admitted to a children's hospital trauma service after October 1, 2005, whose injuries resulted in a Glasgow Coma Scale (GCS) score ≤13 and/or loss of consciousness (LOC) but no history of hearing loss. Screening tympanometry, otoacoustic emissions testing, and/or routine audiometric evaluation were performed as soon as possible after admission. Age, GCS score, Pediatric Trauma Score, Injury Severity Score, presence of head and neck soft tissue injury, temporal bone fracture, skull fracture not involving the temporal bone, midface/mandible fractures, intracranial abnormality on computed tomography, and cervical fracture were analyzed as risk factors for hearing loss.

Results

Seventeen (34%) of the 50 children had abnormal hearing test results. Fischer's exact test showed abnormal test results were most strongly related to temporal bone fracture (p = 0.0041), non-temporal bone skull fracture (p = 0.0211) and younger age (p = 0.0638).

Conclusions

Any child with head trauma and clinical or radiologic evidence of temporal bone fracture should have early hearing evaluation. Using the proposed algorithm to test children with head trauma and GCS ≤13 and/or LOC and age <3 years or any type of skull fracture may help identify children with hearing loss in a more cost effective manner.     

Tissue remodeling in the acute otitis media mouse model

Objectives

Otitis media is an infectious, inflammatory process involving the middle ear space. Chronic inflammation is associated with fibrosis, scarring and osteogenesis within the middle ear, which may contribute to subsequent hearing loss and increase the difficulty of treatment.

Methods

Heat-killed Streptococcus pneumoniae was injected into the middle ears of 8-12 week old Balb/c mice. Control mice were treated with PBS middle ear injections. Middle ears were harvested at 1, 3, 5 and 7 days following injection (n = 8 for each time point). The middle ears were processed using standard RT-PCR techniques. Up- and down-regulation of mRNA expression of various members of the Bone Morphogenetic Protein (BMP), Fibroblast Growth Factor (FGF) and Matrix Metalloproteinase (MMP) families was quantified and compared to PBS treated controls (n = 8 for each time point).

Results

Significant upregulation of MMP2, MMP3 and MMP9 was observed at varying time points (p < 0.05). Significant downregulation of BMP3, BMP4, BMP5 BMP6 and BMP8a was seen at varying time points (p < 0.05). Significant downregulation of FGF3, FGF6, FGF10 and FGFr1 was observed at varying time points (p < 0.05). No significant expression of BMP8b, BMP9, BMP10, FGF5, FGF8, MMP1a, MMP7 and MMP14 was detected within the middle ear.

Conclusions

Inflammation within the middle ear following injection of bacterial products results in changes in the regulation of several tissue remodeling cytokines and proteinases in the mouse model. Further understanding of these molecular processes may allow for the development of treatment modalities aimed at preventing middle ear tissue remodeling.