Otorhinolaryngologic disorders of adolescents: a review

A Nationwide, Population-Based Study of Intelligence and Hearing Loss among 3,104,670 Adolescents

PURPOSE

Epidemiological studies have demonstrated a relationship between general intelligence (GI) in youth and hearing loss (HL). However, no large-scale study assessed the relations of GI in late adolescence with conductive HL (CHL) and sensorineural HL (SNHL), stratified by severity. This study examined the connection between HL and GI in late adolescence.

METHODS

Cross-sectional study on mandatory premilitary recruitment data recorded during 1967-2019 of patients aged 17-19. We compared GI between SNHL, CHL, and those with normal hearing. In addition, we used logistic regression to measure the associations between HL and GI after adjuring for age, sex, education, and socioeconomic status.

RESULTS

Among 3,104,851 adolescents assessed, 20,075 (0.6%) exhibited HL. We categorized GI into three levels for analysis: low (lowest category), medium, and high (reference category). Adjusted odds ratios (ORs) revealed that SNHL was associated with lower GI levels, with ORs ranging from 1.3 (95% confidence interval [CI] 1.4-1.2) for the lowest GI category to 1.1 (95% CI 1.15-0.04) for the medium category. CHL (CHL) also demonstrated significant associations, with ORs from 1.8 (95% CI 1.9-1.6) for the lowest GI level to 1.1 (95% CI 1.2-0.9) for medium. Further analysis revealed a statistically significant, severity-dependent relationship between SNHL and the odds of being in the lowest GI quartile (Q1). Specifically, the ORs for SNHL ranged from 1.2 (95% CI 1.1-1.3) to 1.3 (95% CI 1.1-1.5) as severity increased, indicating a strong link between greater SNHL severity and reduced cognitive performance. In contrast, CHL did not show a consistent correlation between its severity and GI outcomes, with an OR of 1.6 (95% CI 1.2-2.3) across severity levels.

CONCLUSION

We report a strong relationship between HL and GI in late adolescence. SNHL, but not CHL, demonstrated a severity-based decline in GI. The results highlight the value of early, specifically targeted therapies for HL that consider its etiology and degree.

Adolescent otolaryngology

OBJECTIVE

To determine the pattern of disease amongst ambulatory adolescents referred to a pediatric otolaryngology outpatient department.

METHODS

Retrospective chart review of adolescents newly referred to a tertiary pediatric otolaryngology outpatient department over a 12-month period.

RESULTS

One hundred and fifteen patients were included (male 56, female 59) mean age 14.9 years. There were 36 (31%) patients who had previously required otolaryngology management for another condition, and 29 patients with complex medical conditions. Investigations, including audiology and medical imaging, were performed in 35 patients. The patients were managed surgically 34 (30%), medically 28 (24%), referred to other departments 10 (9%) had no intervention 21 (18%), while 22 (19%) failed to attend for follow up.

CONCLUSION

Ambulatory adolescent patients present with a comparable spectrum of otolaryngological problems to other pediatric age groups. These patients appear to be well managed by pediatric otolaryngologists, and there does not seem to be a need to develop a free standing adolescent otolaryngology subspecialty within tertiary pediatric otolaryngology at this time.