This research aims to assess the prevalence, severity and underlying causes of hearing impairments.

This cross-sectional study used multistage stratified sampling to select 2148 individuals from Salyan and Surkhet, following the World Health Organization’s Ear and Hearing Survey Handbook.

Among 1946 participants, 38.9 per cent had hearing impairments, including 15.9 per cent with disabling hearing loss, with severity increasing with age. Ear diseases affected 34.3 per cent, including dull or retracted tympanic membranes (18 per cent), impacted wax (8 per cent), perforated tympanic membrane (6.1 per cent), and abnormal tympanometry (23.1 per cent). The major causes were age-related hearing loss (50.5 per cent), Eustachian tube dysfunction (23 per cent), chronic suppurative otitis media (10.8 per cent), and otitis media with effusion (4.7 per cent). Higher education and immunisation were associated with reduced risk, while chronic conditions, earaches, drainage and tinnitus increased the risk.

The high prevalence of hearing impairment, primarily from preventable causes, underscores the importance of early screening and strengthened primary health care.

Percutaneous ethanol injection (PEI) is a valuable treatment for several health conditions. However, its beneficial and harmful effects in patients with thyroid nodular pathology and metastatic cervical adenopathies have not been assessed in a systematic review.

A systematic review of available scientific literature on the safety, effectiveness, and cost effectiveness of PEI in thyroid nodular pathology and metastatic cervical adenopathies was performed according to Cochrane Collaboration methods and reported in accordance with the PRISMA statement. A cost-minimization analysis was carried out using a decision tree model. Assuming equal effectiveness between two minimally invasive techniques (PEI and radiofrequency ablation [RFA]), the model compared the costs of the alternatives with a horizon of six months from the perspective of the Spanish National Health System.

Three randomized controlled trials (n=157) evaluating PEI and RFA in patients diagnosed with benign thyroid nodules, 96 with predominantly cystic nodules and 61 with solid nodules, were identified. No evidence was found on other techniques or thyroid nodular pathology. No statistically significant differences were observed between PEI and RFA in proportion of volume reduction, symptom score, cosmetic score, therapeutic success, or major complications. No economic evaluations were identified. The cost-minimization analysis estimated the cost per patient of the PEI procedure to be EUR326, compared with EUR4,781 for RFA, with an incremental difference of −EUR4,455.

There are no differences between PEI and RFA in terms of safety and effectiveness, but the economic evaluation determined that the former option is cheaper.