Quality of life measures in otitis media

2013 ◽  
Vol 127 (5) ◽  
pp. 442-447 ◽  
Author(s):  
E J Maile ◽  
R Youngs

AbstractDisabling hearing impairment is the world's most common disability. Traditionally, hearing levels measured by pure tone audiometry have been used to define and quantify hearing loss. The effects of disabling hearing loss on patients' quality of life can be profound, and audiometric data alone may not correlate with quality of life measures. Generic measures of quality of life can be used to compare different diseases, and as such are useful in resource allocation and burden of disease studies. Their disadvantage is that they are not disease-specific and can therefore under-estimate the effects of a disease on patients' quality of life. Disease-specific measures are more sensitive. In chronic otitis media, additional factors such as discharge augment the effect of hearing loss alone on quality of life. Many of the quality of life measures developed for chronic otitis media have been used to assess improvement following reconstructive surgery. Quality of life measures have also been used to assess the effect of paediatric otitis media. Quality of life measures also have utility in the developing world, where hearing impairment is a huge burden.

2018 ◽  
Vol 31 (1) ◽  
pp. 30 ◽  
Author(s):  
Ana Rita Lameiras ◽  
Deodato Silva ◽  
Assunção O´Neill ◽  
Pedro Escada

Introduction: Quality of life is an important measure for health-outcome evaluation. Although otitis media is one of the most common childhood diseases, its impact on Portuguese children’s quality of life is unknown. The aim of this study is to determine the quality of life of Portuguese children with chronic otitis media with effusion and/or recurrent acute otitis media and the short-term impact of transtympanic ventilation tubes, using the Portuguese version of the OM-6 questionnaire, a valid, reliable and sensitive instrument to evaluate the health-related quality of life in children with otitis media.Material and Methods: This study was conducted in a tertiary referral center, to where children are referred from primary care and hospital pediatric consultations. The Portuguese version of the OM-6 questionnaire was applied to children with chronic otitis media with effusion and/or recurrent acute otitis media. The instrument was re-administered at two months postoperatively to a group of children who underwent tympanostomy tube placement, to evaluate the change in quality of life with the surgical procedure.Results: The study involved a sample of 169 children, aged between 6 months and 12 years (mean: 4.20 ± 2.05 years). The average score in the survey was 3.3 ± 1.47, of a maximum of 7 (worst quality of life). The domains ‘caregiver concerns’, ‘hearing loss’ and ‘physical suffering’ had the highest scores. The domain ‘hearing loss’ was correlated with the domain ‘speech impairment’ (rs = 0.41; p < 0.001) and the domain ‘physical suffering’ correlated with the domain ‘activity limitation’ (rs = 0.47; p < 0.001). There was a correlation between the score on ‘hearing loss’ and the presence of conduction hearing loss (χ2 (6) = 24.662; p = 0.022). Children with chronic otitis media with effusion had lower scores on the domain ‘physical suffering’, while children with recurrent acute otitis media had lower scores in the domain ‘hearing loss’ and higher scores in the domain ‘emotional distress’. There was an improvement in the quality of life in all the dimensions studied by the questionnaire after surgery. The improvement was large in 55%, moderate in 15% and small in 10% of the cases. The presence of otorrhea postoperatively did not decrease the quality of life improvement achieved with surgery.Conclusion: Otitis media has a negative impact on Portuguese children quality of life. Tympanostomy tubes improve quality of life related to the middle ear in most children. The application of validated disease-specific questionnaires allows an enhanced understanding of the impact of otitis media on Portuguese children quality of life and of the success of therapeutic measures.


Author(s):  
Danish A. Khan ◽  
Pramod K. Varshney ◽  
M. Yasir Zubair ◽  
M. Anas

Background: Tinnitus is a common ear problem and causes various somatic and psychological effects that has a bearing on the quality of life. Considerably high prevalence, distressing nature of the problem and the fact that it is associated with hearing impairment warrants an early recognition and appropriate timely intervention.Methods: A total of 120 patients (60 with tinnitus and 60 without tinnitus) were included in the study. Data of putative socio-demographic factors and clinical examination findings were collected on a semi-structured questionnaire.Results: The mean age of patients with tinnitus was 38.12±13.39 while that of patients without tinnitus was 40.85±15.26 (p=0.299). Around two-thirds (63.33%, 95% CI, 51.3–75.7%) of patients with tinnitus were males and the other one-third (36.67%, 95% CI, 24.3–48.7%) were females. Two-thirds (66.7%, 95% CI, 54.6–76.7%) of patients with tinnitus belonged to urban locality and the remaining one-third (33.3%, 95% CI, 23.3–45.4%) were from rural areas. On pure tone audiometry (PTA), hearing impairment was detected in 32 (53.3%, 95% CI, 42.0–68.3%) patients with tinnitus as compared to 13 (21.7%, 95% CI, 9.3–35.4%) patients without tinnitus.Conclusions: Tinnitus was associated with hearing loss in considerable proportion irrespective of patients’ own awareness of hearing loss. Therefore, patients should be educated regarding importance of seeking early healthcare. Although the benefits of available treatments are small, and the perception of tinnitus does not wane completely, it improves quality of life and reduces distress resulting from tinnitus.


Author(s):  
Robert Mlynski ◽  
David Bächinger ◽  
Theresa Langanke ◽  
Susen Lailach ◽  
Marcus Neudert ◽  
...  

Abstract Purpose Evaluating the current health state in chronic otitis media (COM), audiologic results are complemented by subjective outcomes, such as health-related quality of life (HRQoL). Two disease-specific instruments assessing HRQoL in COM in German-speaking patients exist, i.e., the chronic otitis media outcome test (COMOT-15) and the Zurich chronic middle ear inventory (ZCMEI-21). Since the psychometric properties of these questionnaires in a concurrent application are unknown, the aim of this study was to compare the COMOT-15 and the ZCMEI-21. Methods HRQoL was assessed in adult COM patients using the COMOT-15 and the ZCMEI-21. Psychometric properties were determined, including response distribution, concurrent validity, internal consistency, correlation to hearing and gender differences. Results In 173 patients (mean age 51.5 years), both questionnaires showed normally distributed scores without strong floor and ceiling effects. The total scores and subscores of both questionnaires exhibited satisfactory internal consistency (Cronbach’s α 0.7–0.9) with the exception of the COMOT-15 hearing subscore (α = 0.94) and the ZCMEI-21 medical resource subscore (α = 0.66). Fair correlations between the air conduction pure-tone average and the total scores were found (COMOT-15: r = 0.36, p < 0.0001; ZCMEI-21: r = 0.34, p < 0.0001). Conclusion In the first study comparing the COMOT-15 and the ZCMEI-21, both questionnaires exhibited satisfactory psychometric properties with several subtle differences. The COMOT-15 has a strong focus on hearing with a probably redundant content of the hearing subscore and may be suited for hearing-focused research questions. The ZCMEI-21 provides a comprehensive assessment of the COM symptom complex and may therefore also be used in research settings, where ear discharge, vertigo or pain should be covered.


Author(s):  
Л. Е. Голованова ◽  
Е. А. Огородникова ◽  
Е. С. Лаптева ◽  
М. Ю. Бобошко

Целью исследования было изучение качества жизни лиц с нарушениями слуха в разных возрастных группах. Обследованы 100 пациентов, обратившихся в городской сурдологический центр для взрослых в связи с нарушением слуха: 50 человек - 34-59 лет, 50 - 60 лет и старше, из которых 32 человека были пожилого возраста (60-74 года)и 18 - старческого (75-86 лет). Степень тугоухости оценивали на основании результатов тональной пороговой аудиометрии. Для исследования качества жизни все пациенты заполняли общий опросник MOS SF-36, отражающий физический и психологический компоненты здоровья, а также специальный опросник HHIА(E)-S для лиц с нарушениями слуха. Установлено, что шкала HHIА(E)-S демонстрирует высокую корреляцию со степенью тугоухости у пациентов моложе 60 лет ( R =0,98; достоверность различий на уровне p <0,05), которая снижается у пациентов 60 лет и старше ( R =0,94; различия в оценках при разной степени тугоухости недостоверны). Значительные трудности в старшей возрастной группе могут быть связаны с тем, что людям пожилого и, особенно, старческого возраста сложно пользоваться слуховыми аппаратами (или они для них неэффективны) и оценивать свои затруднения по шкалам опросника. Целесообразно использовать шкалу HHIА(Е)-S в качестве скринингового инструмента для раннего выявления тугоухости, направления пациентов к сурдологу и своевременного слухопротезирования. The aim of the research was to study the quality of life in hearing impaired patients of different age. 100 patients referred to the city audiology centre because of their hearing disorders were examined: 50 patients from 34 to 59 years old and 50 patients from 60 years and older, from which 32 patients were of older age (60 to 74 years old) and 18 of oldest age (75 to 86 years old). A degree of hearing loss was assessed according to results of pure tone audiometry. To study the quality of life all patients filled in the questionnaire MOS SF-36, which evaluates physical and psychological components of health, and the questionnaire HHIA(E)-S, designed specifically for patients with hearing disorders. The HHIA(E)-S scale was found to show high correlation with hearing loss degree in patients younger than 60 years old ( R =0,98 with statistically significant difference, p <0,05), with decreasing correlation in patients from 60 years and older ( R =0,98; no significant difference while assessing various hearing loss degrees). Considerable difficulties in this age group may be explained by the fact, that older and especially oldest patients have a challenge with hearing aids usage (or they are of low efficiency for them) and with assessing theirs difficulties on the questionnaire scales. The HHIA(E)-S scale is useful as a screening tool for early detection of hearing loss, referral of patients to an audiologist and prompt hearing aid fitting.


Author(s):  
Susen Lailach ◽  
Theresa Langanke ◽  
Thomas Zahnert ◽  
Susan Garthus-Niegel ◽  
Marcus Neudert

Abstract Purpose The aim of this study was to determine whether preoperative depressive symptoms influence health-related quality of life (HRQOL) after middle ear surgery in patients with chronic otitis media (COM). Methods This prospective clinical case study was conducted at a tertiary referral center. All 102 patients who had undergone middle ear surgery for COM were assessed clinically and by audiometric testing (pure tone audiometry) in pre- and postoperative settings. Disease-specific HRQOL was assessed by the validated chronic otitis media outcome test 15 (COMOT-15) and the Zurich chronic middle ear inventory (ZCMEI-21). General HRQOL was measured using the short form 36 (SF-36). Depressive symptoms were assessed using the patient health questionnaire (PHQ-D). The Charlson comorbidity index (CCI) was used to classify comorbidities. The middle ear status was determined using the ossiculoplasty outcome parameter staging (OOPS) index. Results After middle ear surgery, the total COMOT-15 and ZCMEI-21 scores improved significantly (p < 0.001). General HRQOL (total SF-36 score) was unaffected by surgery (p < 0.05). Patients without elevated depressive symptoms had significantly better total scores for the COMOT-15 (p < 0.01), ZCMEI-21 (p < 0.001), and for SF-36 (p < 0.001) postoperatively. The results of the multiple regression analyses show that, after adjusting for the OOPS, CCI, and hearing improvement, preoperative depressiveness was significantly associated with worse postoperative COMOT-15 and ZCMEI-21 outcome scores (β = 0.425 and β = 0.362, p < 0.001). Conclusion Preoperative depressiveness was an essential predictive factor for HRQOL in patients with COM. This should be considered during patient selection to provide more suitable preoperative counseling.


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