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The impact of chronic otitis media on quality of life

Presenting Author: Robin Youngs

Published online by Cambridge University Press:  03 June 2016

Robin Youngs ,
Edward Maile ,
Puran Tharu ,
Hannah Blanchford  and
Rachel Edmiston
Robin Youngs
Affiliation:
Gloucestershire Hospitals NHS Foundation Trust
Edward Maile
Affiliation:
Harvard University
Puran Tharu
Affiliation:
Britain Nepal Otology Service (BRINOS)
Hannah Blanchford
Affiliation:
ENT Department, Darlington Memorial Hospital
Rachel Edmiston
Affiliation:
University Hospital of South Manchester
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Abstract

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Learning Objectives: To present quality of life issues in chronic otitis media, including the impact of corrective surgery. This study focuses in chronic otitis media in a developing world setting.

Hearing impairment is a significant burden in the developing world. However, no suitable quality of life (QoL) measures exist for use in Nepal. We aimed to amend and translate the Glasgow Health Status Inventory (GHSI), assessing QoL at any given time, and the Glasgow Benefit Inventory (GBI), assessing change in QoL following intervention, into Nepali and to assess the impact of ear disease and effect of surgery on QoL.

The GHSI and GBI were translated into Nepali and independently verified. The GHSI was administered by interview to patients before surgery, and the GBI was administered 6 months after surgery. The Mann–Whitney U-test was used for hypothesis testing.

The GHSI was administered to 242 patients. In total, 205 had chronic suppurative otitis media (CSOM) without cholesteatoma and 37 had cholesteatoma. The mean GHSI score was 47.9.

There was no significant difference in GHSI scores between patients with CSOM without cholesteatoma and those with cholesteatoma. The GBI was administered to 161 patients, 73 of whom had also been in the GHSI group. In total, 130 had CSOM without cholesteatoma, 31 had cholesteatoma. The mean GBI score was + 38.4 with no significant difference between disease groups.

Conclusions: Ear disease in Nepal is associated with reduced QoL, and surgical intervention is associated with improved QoL. There is no difference in QoL or benefit following surgery for CSOM between patients with or without cholesteatoma. There are few QoL measures suitable for the developing world. It is essential to invest in these measures to guide health interventions.