Abstract

OBJECTIVE
To determine predicting value of otitis type, age, gender, ear suppuration, disease duration, mucosal changes, cholesteatoma spreading, labyrinthine fistula, size, localization of tympanic membrane perforation, type and stage of its retraction and ossicular chain disruption with sensorineural hearing loss in patients with tubotympanic otitis, cholesteatoma, and tympanic membrane retractions.
STUDY DESIGN
Retrospective case review study.
SETTING
Tertiary referral center.
PATIENTS
Approximately 264 adult patients with unilateral chronic ear disease, 60 adult patients with tympanic membrane retractions, 78 with cholesteatoma, and 126 with tubotympanic otitis.
INTERVENTIONS
Otomicroscopy, pure tone audiometry, impedancemetry were carried out preoperatively. Wall up, wall down tympanoplasty, or two-stage surgery was applied depending on pathology.
MAIN OUTCOME MEASURE
Bone conduction thresholds for 512 to 4,096 Hz.
RESULTS
Mean values of bone conduction thresholds for frequencies 512 to 4,096 Hz were significantly higher in otitis groups than in healthy ears (p = 0.000), without differences between the groups. Ossicular disruption correlated with sensorineural hearing loss in cholesteatoma and tubotympanic otitis for all frequencies; long incus process destruction in tubotympanic ears showed strong negative correlation with sensorineural hearing loss for 512 to 2,048 Hz (linear regression coefficient, intercept was -2.84, -2.48, and -2.41; p = 0.0024, 0.0207, and 0.0076, respectively). Perforation size correlated with sensorineural hearing loss for 512 to 2,048 Hz in tubotympanic otitis (Log regression p = 0.0008, 0.0252, and 0.0267; odds ratio, 1.13, 1.11, and 1.06). Atelectasis correlated with sensorineural hearing loss for 4,096 Hz (p = 0.022).
CONCLUSION
Predictors for sensorineural hearing loss in chronic otitis are otitis itself, age, ossicular disruption, especially of long incus process, extensive labyrinthine fistula, perforation size, and type of retraction.

Links

Publisher Full Text

Authors

Jesic SD, Jotic AD, Babic BB

Institution

School of Medicine University of Belgrade, Serbia. xeniam@sezampro.rs

Source

Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 33:6 2012 Aug pg 934-40

MeSH

Adult
Bone Conduction
Cholesteatoma
Ear Ossicles
Female
Fistula
Hearing Loss, Sensorineural
Humans
Labyrinth Diseases
Linear Models
Logistic Models
Male
Middle Aged
Mucous Membrane
Otitis Media
Otitis Media, Suppurative
Predictive Value of Tests
Stapes
Tomography, X-Ray Computed
Tympanic Membrane Perforation

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22722145