Growth hormone treatment does not affect incidences of middle ear disease or hearing loss in infants and toddlers with turner syndrome

Marsha L. Davenport, Jackson Roush, Chunhua Liu, Anthony J. Zagar, Erica Eugster, Sharon Travers, Patricia Y. Fechner, Charmian A. Quigley

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Context: No randomized, controlled, prospective study has evaluated the effect of growth hormone (GH) on the rates of middle ear (ME) disease and hearing loss in girls with Turner syndrome (TS). Design: A 2-year, prospective, randomized, controlled, open-label, multicenter, clinical trial ('Toddler Turner Study'; August 1999 to August 2003) was carried out. Setting: The study was conducted at 11 US pediatric endocrine centers. Subjects: Eighty-eight girls with TS, aged 9 months to 4 years, were enrolled. Intervention: The interventions comprised recombinant GH (50 μg/kg/day, n = 45) or no treatment (n = 43) for 2 years. Main Outcome Measures: The outcome measures included occurrence rates of ear-related problems, otitis media (OM) and associated antibiotic treatments, tympanometric assessment of ME function and hearing assessment by audiology. Results: At baseline, 57% of the girls (mean age = 1.98 ± 1.00 years) had a history of recurrent OM, 33% had undergone tympanostomy tube (t-tube) insertion and 27% had abnormal hearing. There was no significant difference between the treatment groups for annual incidence of OM episodes (untreated control: 1.9 ± 1.4; GH-treated: 1.5 ± 1.6, p = 0.17). A quarter of the subjects underwent ear surgeries (mainly t-tube insertions) during the study. Recurrent or persistent abnormality of ME function on tympanometry was present in 28-45% of the girls without t-tubes at the 6 postbaseline visits. Hearing deficits were found in 19-32% of the girls at the annual postbaseline visits. Most of these were conductive deficits, however, 2 girls had findings consistent with sensorineural hearing loss, which was evident before 3 years of age. Conclusions: Ear and hearing problems are common in infants and toddlers with TS and are not significantly influenced by GH treatment. Girls with TS need early, regular and thorough ME monitoring by their primary care provider and/or otolaryngologist, and at least annual hearing evaluations by a pediatric audiologist.

Original languageEnglish
Pages (from-to)23-32
Number of pages10
JournalHormone Research in Paediatrics
Volume74
Issue number1
DOIs
StatePublished - Jul 2010

Fingerprint

Ear Diseases
Turner Syndrome
Middle Ear
Hearing Loss
Growth Hormone
Hearing
Incidence
Otitis Media
Middle Ear Ventilation
Ear
Therapeutics
Outcome Assessment (Health Care)
Pediatrics
Audiology
Acoustic Impedance Tests
Sensorineural Hearing Loss
varespladib methyl
Multicenter Studies
Primary Health Care
Clinical Trials

Keywords

  • Conductive hearing loss
  • Otitis media child
  • Preschool
  • Sensorineural hearing loss
  • Somatropin
  • Turner syndrome
  • Tympanostomy tube

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Pediatrics, Perinatology, and Child Health

Cite this

Growth hormone treatment does not affect incidences of middle ear disease or hearing loss in infants and toddlers with turner syndrome. / Davenport, Marsha L.; Roush, Jackson; Liu, Chunhua; Zagar, Anthony J.; Eugster, Erica; Travers, Sharon; Fechner, Patricia Y.; Quigley, Charmian A.

In: Hormone Research in Paediatrics, Vol. 74, No. 1, 07.2010, p. 23-32.

Research output: Contribution to journalArticle

Davenport, Marsha L. ; Roush, Jackson ; Liu, Chunhua ; Zagar, Anthony J. ; Eugster, Erica ; Travers, Sharon ; Fechner, Patricia Y. ; Quigley, Charmian A. / Growth hormone treatment does not affect incidences of middle ear disease or hearing loss in infants and toddlers with turner syndrome. In: Hormone Research in Paediatrics. 2010 ; Vol. 74, No. 1. pp. 23-32.
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abstract = "Context: No randomized, controlled, prospective study has evaluated the effect of growth hormone (GH) on the rates of middle ear (ME) disease and hearing loss in girls with Turner syndrome (TS). Design: A 2-year, prospective, randomized, controlled, open-label, multicenter, clinical trial ('Toddler Turner Study'; August 1999 to August 2003) was carried out. Setting: The study was conducted at 11 US pediatric endocrine centers. Subjects: Eighty-eight girls with TS, aged 9 months to 4 years, were enrolled. Intervention: The interventions comprised recombinant GH (50 μg/kg/day, n = 45) or no treatment (n = 43) for 2 years. Main Outcome Measures: The outcome measures included occurrence rates of ear-related problems, otitis media (OM) and associated antibiotic treatments, tympanometric assessment of ME function and hearing assessment by audiology. Results: At baseline, 57{\%} of the girls (mean age = 1.98 ± 1.00 years) had a history of recurrent OM, 33{\%} had undergone tympanostomy tube (t-tube) insertion and 27{\%} had abnormal hearing. There was no significant difference between the treatment groups for annual incidence of OM episodes (untreated control: 1.9 ± 1.4; GH-treated: 1.5 ± 1.6, p = 0.17). A quarter of the subjects underwent ear surgeries (mainly t-tube insertions) during the study. Recurrent or persistent abnormality of ME function on tympanometry was present in 28-45{\%} of the girls without t-tubes at the 6 postbaseline visits. Hearing deficits were found in 19-32{\%} of the girls at the annual postbaseline visits. Most of these were conductive deficits, however, 2 girls had findings consistent with sensorineural hearing loss, which was evident before 3 years of age. Conclusions: Ear and hearing problems are common in infants and toddlers with TS and are not significantly influenced by GH treatment. Girls with TS need early, regular and thorough ME monitoring by their primary care provider and/or otolaryngologist, and at least annual hearing evaluations by a pediatric audiologist.",
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AU - Liu, Chunhua

AU - Zagar, Anthony J.

AU - Eugster, Erica

AU - Travers, Sharon

AU - Fechner, Patricia Y.

AU - Quigley, Charmian A.

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N2 - Context: No randomized, controlled, prospective study has evaluated the effect of growth hormone (GH) on the rates of middle ear (ME) disease and hearing loss in girls with Turner syndrome (TS). Design: A 2-year, prospective, randomized, controlled, open-label, multicenter, clinical trial ('Toddler Turner Study'; August 1999 to August 2003) was carried out. Setting: The study was conducted at 11 US pediatric endocrine centers. Subjects: Eighty-eight girls with TS, aged 9 months to 4 years, were enrolled. Intervention: The interventions comprised recombinant GH (50 μg/kg/day, n = 45) or no treatment (n = 43) for 2 years. Main Outcome Measures: The outcome measures included occurrence rates of ear-related problems, otitis media (OM) and associated antibiotic treatments, tympanometric assessment of ME function and hearing assessment by audiology. Results: At baseline, 57% of the girls (mean age = 1.98 ± 1.00 years) had a history of recurrent OM, 33% had undergone tympanostomy tube (t-tube) insertion and 27% had abnormal hearing. There was no significant difference between the treatment groups for annual incidence of OM episodes (untreated control: 1.9 ± 1.4; GH-treated: 1.5 ± 1.6, p = 0.17). A quarter of the subjects underwent ear surgeries (mainly t-tube insertions) during the study. Recurrent or persistent abnormality of ME function on tympanometry was present in 28-45% of the girls without t-tubes at the 6 postbaseline visits. Hearing deficits were found in 19-32% of the girls at the annual postbaseline visits. Most of these were conductive deficits, however, 2 girls had findings consistent with sensorineural hearing loss, which was evident before 3 years of age. Conclusions: Ear and hearing problems are common in infants and toddlers with TS and are not significantly influenced by GH treatment. Girls with TS need early, regular and thorough ME monitoring by their primary care provider and/or otolaryngologist, and at least annual hearing evaluations by a pediatric audiologist.

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