Presentation of dizziness in individuals with chronic otitis media: data from the multinational collaborative COMQ-12 study

Abstract Purpose In chronic otitis media (COM), disease chronicity and severity of middle ear inflammation may influence the development of inner ear deficits, increasing the risk of vestibular impairment. This secondary analysis of the multinational collaborative Chronic Otitis Media Questionnaire-12 (COMQ-12) dataset sought to determine the prevalence of vestibular symptoms in patients with COM and identify associated disease-related characteristics. Methods Adult patients with a diagnosis of COM in outpatient settings at nine otology referral centers across eight countries were included. We investigated the presence of vestibular symptoms (dizziness and/or disequilibrium) using participant responses to item 6 of a native version of the COMQ-12. Audiometric data and otoscopic assessment were also recorded. Results This analysis included 477 participants suffering from COM, with 56.2% (n = 268) reporting at least mild inconvenience related to dizziness or disequilibrium. There was a significant association between air conduction thresholds in the worse hearing ear and presence of dizziness [adjusted odds ratio (AOR), 1.01; 95% CI 1.00–1.02; p = 0.0177]. Study participants in European countries (AOR 1.53; 95% CI 1.03–2.28; p = 0.0344) and Colombia (AOR 2.48; 95% CI 1.25–4.92; p = 0.0096) were more likely to report dizziness than participants in Asian countries. However, ear discharge and cholesteatoma showed no association with dizziness in the adjusted analyses. Conclusion Vestibular symptoms contribute to burden of disease in patients with COM and associates with hearing disability in the worse hearing ear. Geographical variation in presentation of dizziness may reflect financial barriers to treatment or cultural differences in how patients reflect on their health state.

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Analysis of tinnitus severity and associated risk factors in patients with chronic otitis media: data from the multinational collaborative COMQ-12 study

The Journal of Laryngology & Otology ◽

10.1017/s0022215121004266 ◽

2022 ◽

pp. 1-30

Author(s):

Bhavesh V. Tailor ◽

John S. Phillips ◽

Ian Nunney ◽

Matthew W. Yung ◽

Can Doruk ◽

...

Keyword(s):

Risk Factors ◽

Otitis Media ◽

Chronic Otitis Media ◽

Tinnitus Severity ◽

Associated Risk Factors ◽

Media Data

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Evaluation of hearing status after type I tympanoplasty

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v24i1.45341 ◽

2020 ◽

Vol 24 (1) ◽

pp. 50-55

Author(s):

Mashuque Mahamud ◽

Mani Lal Aich ◽

Abdullah Al Mamun ◽

Rafiul Alam

Keyword(s):

Otitis Media ◽

Chronic Otitis Media ◽

Neck Surgery ◽

Cross Sectional Study ◽

Type I ◽

Cross Sectional ◽

Female Ratio ◽

The Mean ◽

Type I Tympanoplasty ◽

Air Conduction

Objective: To evaluate hearing outcome after type I tympanoplasty in inactive mucous type of chronic otitis media. Methods: It was a cross-sectional study conducted in the department of Otolaryngology & Head Neck Surgery, Sir Salimullah Medical College and Mitford Hospital, Dhaka, from July 2014 to June 2016. 50 cases were selected by matching inclusion and exclusion criteria. Paired t-test and Z test was used to analyze the variables. P values <0.05 was considered as statistically significant. Results: The mean age was found 28.5 years with range from 15 to 41 years and male female ratio was 1.3:1. All patients had intermittent otorrhoea and varying degree of hearing loss. The mean air conduction threshold was 40.2 dB preoperatively and 27.1 dB post-operatively. Air-bone gap was found 26.9 dB in preoperative and 16.1 dB in post-operative group. The differences were statistically significant between preoperative and post-operative group. Thus mean improvement of air conduction threshold was 13.1 dB and air-bone gap was 10.8 dB. Two third (66.%) patients improved <15 db air conduction thresholds and 17(34%) improved ≥15 db air conduction thresholds. Using the proportion of patients with a postoperative hearing within 40 dB as the criterion, this study showed 46(92%) patients achieving this and 40(80%) patients achieving AB gap within 20 db postoperatively. Conclusion: Improvement of air conduction threshold and AB gap after type I tympanoplasty was statistically significant. Thus from this study it can be concluded that type I tympanoplasty is an effective technique for hearing improvement in inactive mucous type of chronic otitis media. Bangladesh J Otorhinolaryngol; April 2018; 24(1): 50-55

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Evaluation of vestibular symptoms and postural balance control in patients with chronic otitis media

Journal of Vestibular Research ◽

10.3233/ves-200691 ◽

2020 ◽

Vol 30 (1) ◽

pp. 35-45 ◽

Cited By ~ 2

Author(s):

Rafael da Costa Monsanto ◽

Ana Luiza Papi Kasemodel ◽

Andreza Tomaz ◽

Thais Gomes Abrahão Elias ◽

Michael Mauro Paparella ◽

...

Keyword(s):

Otitis Media ◽

Postural Balance ◽

Balance Control ◽

Chronic Otitis Media ◽

Vestibular Symptoms

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Management of labyrinthine fistula using Surdille flap

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20175516 ◽

2017 ◽

Vol 4 (1) ◽

pp. 32

Author(s):

Rashmi P. Rajashekhar ◽

Vinod V. Shinde

Keyword(s):

Otitis Media ◽

Chronic Otitis Media ◽

Semicircular Canals ◽

Canal Wall ◽

Endochondral Bone ◽

Labyrinthine Fistula ◽

Modified Radical Mastoidectomy ◽

Canal Wall Down ◽

Vestibular Symptoms ◽

Postoperative Vertigo

Background: Labyrinthine fistula (LF) is the most common intra-temporal complication of squamosal chronic otitis media represents an erosive loss of endochondral bone overlying the semicircular canals without loss of perilymph. Main treatment of LF is surgical. The aim of our study is to discuss its incidence and sex ratio. The main objective is to describe the audio-vestibular results after closure of labyrinthine fistula by our technique using surdille flap. Methods: 234 patients with squamosal chronic otitis media presented to our institution in a period of 24 months. Out of 234 patients, 22 patients were having labyrinthine fistula. Eleven patients had fistula test positive. Rest eleven patients were found to have LF intra-operatively. All patients underwent canal wall down modified radical mastoidectomy (MRM). Treatment of LF was done surgically by using surdille flap in all the cases. Post operatively Audio-vestibular results of labyrinthine fistula surgery by our technique were studied. Results: The results show that the cholesteatoma matrix can be removed from the fistula. Removal of the fistula generally improves the vestibular symptoms. In all patients canal wall down procedure was done with surdille flap seal over LF. In our study, incidence of LF was 9.40% and none of the patients ended up with postoperative deafness. Hearing improved in 36.40% patients whereas it remained unchanged in rest of the cases. Conclusions: Labyrinthine fistula, very commonly seen in the lateral semicircular canal has incidence of 5-10% reported in many studies. We demonstrated that open technique with removal of matrix and sealing with three layers may be a valuable choice for the surgical treatment of LF with little risk for cochlea-vestibular functions. Advantage of using surdille flap (sealing the fistula with three layers) is that it decreases the possibility of postoperative vertigo.

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Single centre experience of ossiculoplasty using different materials: a subjective and objective evaluation

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20204632 ◽

2020 ◽

Vol 6 (11) ◽

pp. 2058

Author(s):

Vijay Kumar ◽

Kranti Bhavana ◽

Bhartendu Bharti

Keyword(s):

Hearing Loss ◽

Otitis Media ◽

Chronic Otitis Media ◽

Objective Evaluation ◽

Neck Surgery ◽

Postoperative Result ◽

Ossicular Reconstruction ◽

Single Centre Experience ◽

Associated Symptoms ◽

Air Conduction

Background: Chronic otitis media has serious impact over the ossicular integrity in middle ear resulting in ossicular necrosis and various grades of hearing loss along with other associated symptoms. Tympanomastoidectomy with ossicular reconstruction using various materials can improve the symptoms.Methods: A retrospective study of 50 patients underwent tympanomastoidectomy with ossiculoplasty in Department of ENT and Head and Neck Surgery at AIIMS Patna from April 2017 to 2018. Patients with chronic otitis media having ossicular necrosis with ABG (air bone gap) more than 25 dB were included in this study. PORP (partial ossicular reconstruction prosthesis) and TORP (total ossicular reconstruction prosthesis) were used as ossicular reconstruction after clearance of disease. This study was expressed as subjective and objective evaluation following ossiculoplasty. Results: Fifty patients having chronic otitis media with decreased hearing and other associating symptoms were included in this study. Preoperative air conduction threshold was 55.32 dB with preoperative ABG was 44.24 dB. Postoperative result was summarised as postoperative AC threshold was 32.72 dB with gain of 22.60 dB with ABG 25.45 dB.Conclusions: Chronic otitis media may lead to ossicular necrosis and various grade of hearing loss. A proper technique and skilled tympanomastoidectomy with ossiculoplasty can improve the symptoms of chronic otitis media.

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Mobile, one stage, bilateral ear surgery for chronic otitis media patients in remote areas

The Journal of Laryngology & Otology ◽

10.1017/s0022215109005738 ◽

2009 ◽

Vol 123 (10) ◽

pp. 1108-1113 ◽

Cited By ~ 5

Author(s):

P Homøe ◽

H C Florian Sørensen ◽

M Tos

Keyword(s):

Otitis Media ◽

Pure Tone ◽

Chronic Otitis Media ◽

Ear Surgery ◽

Suppurative Otitis Media ◽

Remote Areas ◽

Pure Tone Average ◽

One Stage ◽

Air Conduction

AbstractObjectives:We evaluated the results of mobile, one stage, bilateral ear surgery conducted in Greenland, where chronic otitis media with and without suppuration is prevalent. The study aimed to increase the number of operations conducted and to reduce the cost of ear surgery in remote areas.Materials and methods:The study was longitudinal and prospective, with a two-year follow up. Seventeen East Greenlandic patients with bilateral chronic suppurative otitis media or chronic otitis media were selected. Their median age was 16 years; 53 per cent were female and 47 per cent male. Hearing was assessed using median air conduction pure tone average gain, and the ‘take rate’ (i.e. the percentage of total ears with a closed perforation) was evaluated.Results:All patients attended for follow up. Eighty-two per cent had at least one perforation closed, and the overall take rate was 65 per cent of the 34 ears. The median air conduction pure tone average gain after two years was 18 dB and 13 dB for the right and left ears, respectively. Fourteen patients (82 per cent) obtained an air conduction pure tone average hearing level of ≤25 dB in at least one ear. In total, 71 per cent of the patients were satisfied. There were no hearing hazards.Conclusions:The results of mobile, one stage, bilateral ear surgery conducted in Greenland for long-lasting chronic suppurative otitis media and chronic otitis media were acceptable and safe, and more ears underwent surgery at reduced cost compared with unilateral ear surgery.

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Mechanism of Hearing Loss in Irradiated Ears: A Long-Term Longitudinal Study

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940111001002 ◽

2001 ◽

Vol 110 (10) ◽

pp. 904-906 ◽

Cited By ~ 26

Author(s):

Yi-Ho Young ◽

Ying-Chih Lu

Keyword(s):

Hearing Loss ◽

Otitis Media ◽

Middle Ear ◽

Otitis Media With Effusion ◽

Bone Conduction ◽

Chronic Otitis Media ◽

Pure Tone Audiometry ◽

Tube Function ◽

The Mean ◽

Air Conduction

A 10-year longitudinal follow-up study of hearing was conducted in patients with nasopharyngeal carcinoma (NPC) in order to elucidate the mechanism of hearing loss in irradiated ears. Ten NPC patients were subjected to a battery of audiological tests before irradiation and 6 months, 5 years, and 10 years after irradiation. The tests included pure tone audiometry, tympanometry, eustachian tube function testing, and myringotomy to confirm middle ear effusion. The prevalences of otitis media with effusion (OME) were 25%, 25%, 40%, and 25% at the 4 testing periods described above, respectively. The prevalences of chronic otitis media were 0%, 0%, 15%, and 25%, respectively. In myringotomized ears (n = 17), the mean hearing levels for both air conduction and bone conduction were preserved from the preirradiation period to 10 years after irradiation. In contrast, in grommeted ears (n = 3), the mean hearing levels for both air conduction and bone conduction deteriorated progressively from the preirradiation period to 10 years after irradiation. We conclude that hearing can be preserved in NPC patients 10 years after irradiation if middle ear inflammation is well controlled. We do not recommend grommet insertion in irradiated NPC patients with OME, as it may result in persistent otorrhea and hearing deterioration.

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Evaluating Success of Surgery in Mucosal and Squamosal Chronic Otitis Media: A Retrospective Study

Bengal Journal of Otolaryngology and Head Neck Surgery ◽

10.47210/bjohns.2018.v26i2.167 ◽

2018 ◽

Vol 26 (2) ◽

pp. 99-104

Author(s):

Nilank Saroha ◽

Nitin Tomar

Keyword(s):

Hearing Loss ◽

Retrospective Study ◽

Otitis Media ◽

Chronic Otitis Media ◽

Type I ◽

Radical Mastoidectomy ◽

Type Iii ◽

Mucosal Disease ◽

Modified Radical Mastoidectomy ◽

Air Conduction

This study attempted to document success of surgery postoperatively, be it type I tympanoplasty or type III tympanoplasty with or without modified radical mastoidectomy. Materials and Methods This retrospective study involved 90 patients of Chronic Otitis Media who underwent surgery in the Department of Otorhinolaryngology in a tertiary care centre in the state of Uttar Pradesh. Results At 3 week postoperatively, 83 patients (92.22%) had successful uptake of graft. Overall successful graft uptake was reduced to 87.78% (79 patients) after 3 months. Postoperatively, after 3 months, 90% of the patients (n=81) reported improvement in hearing. Preoperatively, 89.71 % patients of mucosal disease and 63.64% of squamosal disease had 21-40 dB hearing loss. Postoperatively, 88.24% patients with mucosal disease and 63.64% of squamosal disease had no conductive hearing loss. There was statistically significant gain in air conduction postoperatively. Average improvement in AB gap was also notably significant postoperatively in both subgroups. Conclusion Both type I and type III tympanoplasty give excellent response in term of graft uptake and postoperative hearing. Abbreviations: COM-Chronic Otitis Media, AC-Air Conduction, AB-Air Bone, TP-Tympanoplasty, MRM-Modified Radical Mastoidectomy

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