Abstract
Background: Chronic Otitis Media (COM) is a commonly occurring disease worldwide. Timely management is required as this disease is capable of causing serious complications and can lead to long term pain and discharge from the ear. Traditionally, this disease is associated with conductive deafness however we organized a study to analyse the component of sensorineural deafness in patients presenting with COM.
Methods: We conducted a study on 75 patients of 5-40 years of age with unilateral complaints of ear discharge and hearing loss. Group COM comprises of the ears with complaints of unilateral ear discharge while the Control Group consisted of the contralateral healthy ears of the same patient included in the study. After detailed history, examination and relevant investigation findings were documented.
Results: It was inferred that COM is associated with sensorineural (SN) loss in small majority of patients. No significant co-relation was established between the duration of discharge and degree of SN loss (r = 0.183, p> 0.05). The average age was 25.3 years. There was no significant male or female preponderance. Significant higher bone conduction thresholds were found in the affected ear than in the normal ear for each frequency (500, 1000, 2000 and 4000Hz) (p < 0.05), which progressed with increasing frequency. The prevalence also increased with age of patient and duration of disease.
Conclusions: A significant degree of SNHL in patients with COM was noted in this study. SNHL occurred in 14% of the patients with COM, and was correlated with older age and longer duration of ear disease. There was no correlation between the degree of SNHL and duration of disease. It can be further studied that whether an early surgery in COM has any effect on impending sensorineural hearing loss.
Keywords: Chronic otitis media, Conductive hearing loss, Sensorineural hearing loss.
References
- Acuin J; Extracts from “Concise clinical evidence”: chronic suppurative otitis media. British Medical Journal 2002; 325; 73: 1159–60.
- Mills RP (1997) Management of chronic suppurative otitis media. In: Kerr AG, Booth JB (eds) Scott-Brown’s otolaryngology, vol. 3, 6th edn. Butterwoth-Heinemann, Oxford, 1997.1-10.
- De Azevedo AF, Pinto DC, de Souza NJ, Greco DB, Gonçalves DU. Sensorineural hearing loss in chronic suppurative otitis media with and without cholesteatoma. Braz J Otorhinolaryngol 2007;73:671-4.
- Paparella MM, Oda M, Hiraide F, Brady. Pathology of sensorineural hearing loss in otitis media. Ann Otol Rhinol Laryngol 1972;81:632-47.
- Cusimano F, Cocita VL, D’ Amico A. Sensorineural hearing loss in chronic otitis media. J Otolaryngol Otol 1989;103:158-63.
- Dumich J, Harner SG: Cochlea function in chronic otitis media. Laryngoscope 1983;93:583-6.
- Kaplan DM, Fliss DM, Klaus M, Dagan R, Leiberman A. Audiometric findings in children with chronic suppurative otitis media without cholesteatoma. Int J Pediatr Otorhinolaryngol 1996;35:89-96.
- Browing GG, Gatehouse S. Hearing in suppurative otitis media. Ann Otol Rhinol Laryngol 1989;98:245-50.
- Levine BA, Shelton C, Berliner KI, Sheehy JL. Sensorineural loss in chronic otitis media. Is it clinically significant? Arch Otolaryngol Head Neck Surg 1989;115:814-6.
- MacAndie C, O´Reilly BF. Sensorineural hearing loss in chronic otitis media. Clin Otolaryngol 1999;24:220-2.
- Kirtane MV, Merchant SN, Raje AR et al. Sensorineural hearing loss in chronic otitis media--a statistical evaluation. Journal of postgraduate medicine. 1985 Oct 1;31(4):183.
- Erkan Mustafa el al., “Bacteriology of Chronic Suppurative Otitis Media”.Ann. OtolrhinolCaryng at 1994; 771-4.
- Indudharan R. Vijaya D., “Microbiological Study of Chronic Suppurative Otitis Media”.I.J.O. 1998.Dec. 4(4); 172-14.
- Gulati SK, “Investigative Profile in patients of Chronic Suppurative Otitis Media” .J.O. 1997 (June); 3(2); 59-62.
- Tuz Mustafa, Harun Dooru, Fehmi Doner et al. Sensorineural hearing loss associated with chronic suppurative otitis media. S.D.U. Tip Fak. Derg 2006;13(1):1-4.
- Kaur K, Sonkhya N, Bapna AS. Chronic suppurative otitis media and sensorineural hearing loss: Is there a correlation?.Indian Journal of Otolaryngology and head and neck surgery. 2003 Mar 1;55(1):21-4.
- Papp Z, Rezes S, Jókay I et al. Sensorineural hearing loss in chronic otitis media. Otology &neurotology. 2003 Mar 1;24(2):141-4.
- Paparella MM. Sensorineural hearing loss in chronic otitis media and mastoiditis. Am Acad Ophthalmol Otolaryngol. 1970;74:108-15.
- English GM, Northern JL, Fria TJ. Chronic otitis media as a cause of sensorineural hearing loss.Archives of otolaryngology. 1973 Jul 1;98(1):18-22.
- Kirtane MV, Merchant SN, Raje AR et al. Sensorineural hearing loss in chronic otitis media--a statistical evaluation. Journal of postgraduate medicine. 1985 Oct 1;31(4):183.
- Noordzij J.P., Dodson E.E., Ruth R.A. et al. Choronic otitis media and sensorineural hearing loss: is there a clinically significant relation: American Journal of Otology. 1995;16:420-3.
- Kolo ES, Salisu AD, Yaro AM et al. Sensorineural hearing loss in patients with chronic suppurative otitis media. Indian Journal of Otolaryngology and Head & Neck Surgery. 2012 Mar 1;64(1):59-62.
- Redaelli de Zinis LO, Capovecchi C, Parrinello G, Antonelli AR. Predisposing factors for inner ear hearing loss association with chronic otitis media. Int J Audiol 2005;44:593-8.
- Spandow O, Anniko M, Hellstrom S. Inner ear disturbances following inoculation of endotoxin into the middle ear. ActaOtolaryngol.1989; 107:90-6.
- Goycoolea MV, Paparella MM, Juhn SK, Carpenter AM. Oval and round window changes in otitis media. Potential pathways between middle and inner ear. Laryngoscope 90:1387-91
- Engel F, Blatz R, Kellner J, Palmer M, Weller U, Bhadki S. Breakdown of round window membrane permeability barrier evoked by streptolysin O: Possible etiologic role in the development of sensorineural hearing loss in acute otitis media. Infect Immun 1995;63:1305-10.
- Browning GG, Gatehouse S, Calder IT (1998) Medical management of active chronic otitis media: a controlled study. J Laryngol Otol 102:491-5.
Corresponding Author
Dr Bhawana Pant
Associate Professor ENT Dept GMC Haldwani Uttrakhand
DOI: https://dx.doi.org/10.18535/jmscr/v7i3.63
