Risk factors for sensorineural hearing loss in pediatric chronic otitis media.

OBJECTIVES: To assess the clinical significance of sensorineural hearing loss (SNHL) in a group of pediatric patients suffering from unilateral chronic otitis media (COM) with or without cholesteatoma, using the contralateral healthy ear as a control, and to define risk factors for the development of SNHL in such patients.

METHODS: The subjects of this retrospective study were 124 pediatric patients with unilateral COM admitted for surgery. Mean age at surgery was 13.3±3.2 years (range, 7-18) and mean duration of the disease was 88.4±45.0 months (range, 6-192 months). The preoperative pure-tone average value (PTA) for bone conduction (BC) was calculated in each ear (BC-PTA) as the average of BC thresholds at 500, 1000, 2000, and 4000Hz. Potential risk factors for SNHL that we evaluated were demographics, duration of disease, presence of cholesteatoma, and previous otologic history.

RESULTS: Mean BC-PTA values in the diseased ears prior to surgery differed significantly from those in the healthy ears (12.74±8.75dB and 9.36±6.33dB, respectively; P<0.01). The degree of SNHL in the diseased ear at 2000Hz was found to be significantly correlated with the presence of cholesteatoma and with age above 10 years.

CONCLUSIONS: One of the complications of COM, with or without cholesteatoma, in addition to the conductive hearing loss, is the development of clinically significant SNHL. It is therefore imperative to actively treat pediatric patients diagnosed with COM, with the aim of preventing the possible development of SNHL.