How does otitis media with effusion history affect spatial auditory processing and listening effort?

Purpose: To evaluate the impact of otitis media with effusion (OME) history on spatial auditory processing and listening effort (LE) in children with normal hearing thresholds. Methods: Seventeen children with a history of OME, whose hearing thresholds had returned to normal (mean age 7.8 years), and 22 age-matched controls (mean age 8 years) participated in the study. Assessments included audiometric evaluations, an adaptive speech-in-noise task under spatial and non-spatial conditions, pupillometry to measure changes in pupil dilation during sentence recognition in noise, and an auditory digit span task to assess working memory. Results: Children with a history of OME required higher signal-to-noise ratios (SNRs) under spatial separation conditions and exhibited greater pupil dilation in non-spatial conditions, reflecting increased LE. They also demonstrated significantly lower backward digit span scores than the control group. Conclusions: Results indicate that children with a history of OME required compensation (in speech reception thresholds in noise and increased pupil dilation) in each auditory condition. These findings suggest that OME may have long-term effects on auditory and cognitive functioning, even after hearing thresholds return to the normal range. Early identification and intervention are crucial to address these challenges. Long-term monitoring is also recommended, as sustained exposure to normal auditory input may support improvements in binaural processing and spatial listening abilities, reducing the impact of early fluctuating conductive hearing loss on learning and communication.