Quality of Life after Surgical Treatment for Chronic Otitis Media: A Systematic Review of the Literature

Abstract

This systematic review aims to (a) define what instruments are available to measure quality of life (QoL) in patients undergoing tympanoplasty for chronic otitis media (COM) and what is the most commonly selected timing to do so; (b) compare outcomes from different surgical techniques; and (c) describe any reported correlation between subjective and functional results. This review was conducted following the PRISMA statement recommendations. Of the 151 articles screened, 24 were included. Most studies had a prospective design. The mean age at surgery was 44.5 years. A microscopic retroauricular approach was the most common surgical technique. Most articles included both primary and revision surgeries. The most commonly used questionnaire was the Glasgow Benefit Inventory (GBI), followed by the Chronic Ear Survey (CES), the Chronic Otitis Media Outcome Test 15 (COMOT-15) and the Zurich Chronic Middle Ear Inventory (ZCMEI-21). Questionnaires were administered about 12 months after surgery in most studies. Ten studies reported possible associations between hearing results and QoL. QoL assessment after COM surgery variably relies on disease-specific and non-specific questionnaires. Patients are usually evaluated 12 months after surgery, and this appears to be a suitable timing to contrast the possible bias effect of different tympanoplasty techniques associated with different healing times. A comparison between QoL outcomes in different surgical approaches cannot be made, as several influencing factors have not been detailed in the included studies. Few studies have investigated the correlation between subjective and objective outcomes of tympanoplasty for COM so far.

Implantable hearing devices in clinical practice. Systematic review and consensus statements

“…In cases of chronic otitis media with or without cholesteatoma, the main surgical goal is eradication of the disease, while restoration of hearing is desirable but not always achievable. As reported by Lucidi et al 22 in 2022, higher post-operative hearing thresholds correlate with worse outcomes on most questionnaires assessing quality of life. Percutaneous BCDs require the insertion of an abutment in a reliable and simple procedure.…”

Health-related quality of life after otologic surgical treatment for chronic otitis media: systematic review

“…Studies that assess the impact of surgical treatment on the HRQoL of COM patients are increasing. Recently, a systematic review (24) focused on the available instruments to measure HRQoL in COM patients, the timing of the postoperative measurement, and the comparison between different surgical techniques. However, there is no comprehensive overview that objectifies the impact of otologic surgical treatments for COM on the patients' HRQoL, measured exclusively prospectively.…”

Otitis media: recent advances in otitis media vaccine development and model systems

“…This is especially important for preschool children whose speech development may be delayed by this condition ( Simon et al, 2018 ). The typical characteristics of COM are ear pain, ear discharge, and hearing impairment which may persist even after surgery, leading to many restrictions in daily life ( Lucidi et al, 2022 ). Pro-inflammatory cytokines like TNF-α and IL-1, produced to combat bacterial infection during an AOM episode, set up an inflammatory response leading to the evolution of COM, which may include epithelial remodeling ( Juhn et al, 2008 ).…”