الفهرس 
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Abstract
Otitis media with effusion (OM) refers to inflammation of the middle ear. It is very common in childhood, with the average toddler having two to three episodes. A middle ear effusion if less than 3 weeks is considered acute otitis media with effusion, while effusion that last longer than 3 months represent chronic otitis media.
The presence of OM with effusion may result in many sequalae on hearing, language development, auditory processing and scholastic achievement. Many cases of chronic otitis media with effusion have the fluctuating nature of hearing loss (which may alternate with periods of normal hearing) leads to an inconsistent sound stimulus to the auditory central nervous system, making it difficult for the child to perceive the sounds of speech.
This study was done to investigate the auditory processing patterns objectively in children with history of otitis media with effusion using complex ABR. The language development and scholastic achievement in those children was correlated with c-ABR the study group children comprised twenty two children with history of chronic and recurrent attack of O.M and control group children is with normal hearing sensitivity. Their age ranged from 6-12years. All children were submitted to full medical, otological history of middle ear problem, history of scholastic achievement, otological examination, IQ evaluation, questionnaire of central auditory processing in Arabic Language and Language assessment (phoniatric department). Basic audiologic evaluation was done in the form of (pure tone audiometry, speech and tympanogram).
Complex auditory brain stem response was applied to all children using:
Stimulus parameters:
• Type: 40-ms /da/ syllable it consists of onset noise burst during the first 10 ms and formant transition between the consonant and a steady-state vowel. The stimulus was generated by Intelligent Hearing System Company and included in speech auditory brain response software.
• Intensity: 80 dBSPL.
• Polarity: alternating
• Presentation rate: of 11p/sec.
• Mode of delivery: stimuli were presented monaurally to the right ear via an ER3A- insert phone.
Recording parameters:
• Electrode Montage: The active electrode was placed on the high frontal (Fz), the negative electrode on the right side and the reference electrode on the left side.
• Number of sweeps: 2000.
• Filter: band passes of 100 to 2000 Hz.
• Analysis period: 75 msec including 15 msec pre-stimulus recording.
Result of the study pointed to statistically significant difference in Arabic CAPD questionnaire scores and scholastic achievement scores between control and study group. Complex ABR showed significant statistical difference in the VA slope, C,D,E,O latency and FFR between the two study groups. Positive statistical correlation was found between duration of otitis media and complex ABR at VA slope and O latency, language age and listening, language in central questionnaire and scholastic achievement. Also, positive statistical correlation was found between complex ABR and CAPD questionnaire and scholastic achievement.
No statistical correlation existing between the complex ABR and age.
In conclusion, children with a history of chronic otitis media with effusion had deficient neural timing in response to the onset and offset of the transient speech stimuli. This might resulting in impairment of speech encoding at the brain stem. That in turn affect on language development, scholastic achievement and auditory processing abilities.