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Clinical Significance of Sensorineural Hearing Loss in Pediatric Chronic Otitis Media

Presenting Author: Noam Yehudai

Published online by Cambridge University Press:  03 June 2016

Noam Yehudai  and
Michal Luntz
Noam Yehudai
Affiliation:
Bnai Zion Medical Center, Technion – The Bruce Rappaport Faculty of Medicine, Haifa, Israel
Michal Luntz
Affiliation:
Bnai Zion Medical Center, Technion – The Bruce Rappaport Faculty of Medicine, Haifa, Israel
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Abstract

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Learning Objectives: to promote awareness to the long term effects of chronic OM in terms of SNHL.

Introduction: Hearing loss is considered a common complication and sequela of chronic otitis media (COM). The loss is usually conductive, but sensorineural involvement also occurs. Clinically significant sensorineural hearing loss (SNHL) has been reported in adults with COM; however its significance in children is still unclear. The aim of the study is to assess the severity of SNHL in single sided COM, in a group of children, using the contra-lateral healthy ear as a control and to define risk factors for the development of SNHL in COM. Characterizing these risk factors will assist in better defining treatment indications for COM and thus reduce the occurrence of SNHL.

Methods: The study cohort included 124 children with unilateral COM operated between 1997 and 2010. Mean age at surgery was 13.3 ± 3.2 years (range, 7–18 years), and mean duration of disease was 88.4 ± 45.0 months (range, 6 -192 months). Bone conduction (BC) pure tone average (PTA) of the two ears was calculated as the average of BC thresholds at 500, 1000, 2000 and 4000 Hz. The parameters evaluated included: demographics (age, sex, and side), duration of disease, presence and location of cholesteatoma, previous otologic history and previous ear surgery.

Results: A statistically significant difference in BC-PTA was found between the diseased ear (12.74 ± 8.75 dB) and the healthy ear (9.36 ± 6.33 dB) (p < 0.01). Statistically significant correlation was found between the level of SNHL in the diseased ear, age and the presence of cholesteatoma.

Conclusions: One of the complications of chronic COM is the development of SNHL in addition to conductive hearing loss. It is imperative to actively treat COM patients in order to prevent the expected development of SNHL. An insistent approach to patients presenting with these factors is mandatory since they are prone to develop a more severe form of SNHL.