CHRONIC OTITIS-MEDIA AND SENSORINEURAL HEARING-LOSS - IS THERE A CLINICALLY SIGNIFICANT RELATION

Previous investigations into the possible relation between chronic oti tis media (COM) and sensorineural hearing loss (SNHL) have resulted in differing results and conclusions. A retrospective study was conducte d to examine the relation between COM and SNHL, using strict selection criteria for cases so as to eliminate co-variables. In addition, vari ous COM parameters were studied to determine if a correlation with the severity of the SNHL existed. At the University of Virginia, charts o f all patients undergoing chronic ear surgery from September 1983 to M arch 1993 were reviewed. Sixty-nine patients met the following criteri a: unilateral COM and no history of head trauma, meningitis, post-trau matic tympanic membrane perforation, labyrinthine fistula, or coexisti ng otologic condition of either ear. From these charts, audiograms wer e then analyzed for evidence of SNHL, defined as the difference in pre operative bone conduction thresholds between diseased and control (nor mal contralateral) ears. Mean bone conduction differences were small: -0.5 dB at 500 Hz, 0.9 dB at 1000 Hz, 4.4 dB at 2000 Hz, and 3.6 dB at 4000 Hz. There were nonsignificant bone conduction threshold differen ces that trended toward greater SNHL with diseased mucosa and choleste atoma at 2000 and 4000 Hz. There was no consistent correlation between severity of SNHL and presence of otorrhea, degree of ossicular erosio n, or duration of disease. The authors conclude that COM may cause SNH L, but in the vast majority of patients this loss is not clinically si gnificant.