Predictors for sensorineural hearing loss in patients with tubotympanic otitis, cholesteatoma, and tympanic membrane retractions.
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.


METHODS
Retrospective case review study.


METHODS
Tertiary referral center.


METHODS
Approximately 264 adult patients with unilateral chronic ear disease, 60 adult patients with tympanic membrane retractions, 78 with cholesteatoma, and 126 with tubotympanic otitis.


METHODS
Otomicroscopy, pure tone audiometry, impedancemetry were carried out preoperatively. Wall up, wall down tympanoplasty, or two-stage surgery was applied depending on pathology.


METHODS
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).


CONCLUSIONS
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.
School of Medicine University of Belgrade, Serbia. xeniam@sezampro.rs
Snezana Dragoljub
SD
Jesic
Ana Dragan
AD
Jotic
Borivoj Bogdan
BB
Babic
D000328:Adult; D001844:Bone Conduction / Q000502:physiology; D002781:Cholesteatoma / Q000150:complications*; D004429:Ear Ossicles / Q000473:pathology; D005260:Female; D005402:Fistula / Q000473:pathology; D006319:Hearing Loss, Sensorineural / Q000209:etiology*; D006801:Humans; D007759:Labyrinth Diseases / Q000473:pathology; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D010033:Otitis Media / Q000150:complications*; D010035:Otitis Media, Suppurative / Q000150:complications; D011237:Predictive Value of Tests; D013199:Stapes / Q000473:pathology; D014057:Tomography, X-Ray Computed; D018058:Tympanic Membrane Perforation / Q000150:complications*