Abnormal CT findings are risk factors for otitis media-related sensorineural hearing loss.
OBJECTIVE
Inflammatory processes in chronic otitis media (COM) can damage the inner ear, resulting in sensorineural hearing loss (SNHL). The purpose of this study was to evaluate risk factors by computed tomography (CT) findings for COM-related SNHL in patients with unilateral COM.


METHODS
Records from January 2009 to December 2012 of 231 patients with unilateral COM and a normal contralateral ear were retrospectively evaluated. Bone conduction thresholds were calculated for each ear at 0.5, 1, 2, and 4 kHz. If bone conduction threshold averaged across the four frequencies of the COM ear was 10 dB greater than that of the contralateral ear, the patient was classified under the SNHL group. Temporal bone CT images were analyzed to determine the presence or absence of soft tissue density in the attic (medial/lateral), antrum, oval window niche, and round window niche. Multivariate analysis of sex, age (< 50 years; ≥ 50 years), disease duration (< 20 years; ≥ 20 years), perforation size (small; moderate; large) and the presence of soft tissue density in the attic (medial/lateral), antrum, oval window niche, and round window niche was used to determine the factors related to COM-related SNHL.


RESULTS
Of the 231 patients, there were 51 patients (22.1%) in the SNHL group and 180 patients (77.9%) in the non-SNHL group. Multivariate analyses showed that the presence of soft tissue density in the antrum (odds ratio [OR] 3.80; 95% confidence interval [CI] 1.74-8.32; p = 0.001), age ≥ 50 years and more (OR 3.32; 95% CI 1.62-6.81; p = 0.001), disease duration ≥ 20 years (OR 2.80; 95% CI 1.31-6.02; p = 0.008), and the presence of soft tissue density in the round window niche (OR 2.42; 95% CI 1.12-5.21; p = 0.024) were independently related to COM-related SNHL.


CONCLUSIONS
COM-related SNHL was present in 22% of ears with COM. The presence of soft tissue density in the antrum, determined from temporal bone CT, increased the OR of SNHL to 3.8. Age, disease duration, and the presence of soft tissue density in the round window niche were also independent predicting factors for SNHL. These findings may be used as informative references for patients with COM.
1Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; 2Department of Otolaryngology, Kangwon National University, Chuncheon, Korea; and 3Department of Otolaryngology, Jeju Seogwipo Medical Center, Seogwipo, Korea.
Chan Joo
CJ
Yang
Tae Su
TS
Kim
Byoung Soo
BS
Shim
Joong Ho
JH
Ahn
Jong Woo
JW
Chung
Tae Hyun
TH
Yoon
Hong Ju
HJ
Park
D000328:Adult; D000367:Age Factors; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D001844:Bone Conduction; D002908:Chronic Disease; D007758:Ear, Inner / Q000000981:diagnostic imaging*; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000000981:diagnostic imaging*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010033:Otitis Media / Q000000981:diagnostic imaging*; D010046:Oval Window, Ear / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D012307:Risk Factors; D012405:Round Window, Ear / Q000000981:diagnostic imaging; D013701:Temporal Bone / Q000000981:diagnostic imaging*; D013997:Time Factors; D014057:Tomography, X-Ray Computed