Sub-clinical middle ear malfunctions in elderly patients; prevalence, pattern and predictors

Abstract

Background: Little is known about functioning of the middle ear with advancing age. Objectives: To estimate the prevalence and describe tympanometric patterns of sub-clinical middle ear malfunctions, (S-MEM) in elderly patients. It also assessed clinical factors that could predict S-MEM. Methods: Cross-sectional, analytical study of patients aged ≥ 60 years in a tertiary hospital in Nigeria between 2011-2014. Pure tone audiometry (PTA), tympanometry and acoustic reflexes were recorded. S-MEM was based on audiometric and tympanometric evident abnormalities. Descriptive, univariate and multivariate analyses performed to detect independent clinical predictors of S-MEM at p-value of <0.05. Results: 121 patients, M: F of 1.1:1. Mean age was 70.1 ± 6.2 years, 77.7% were married. Prevalence of S-MEM was 21.5%. Abnormal tympanometric tracings were type AS>C>B>AD. The parameters that were statistically-significant on univariate analyses were subjected to logistic regression analysis which confirmed previous head injury, diabetes, osteoarthritis of knee joint, and absent acoustic reflex as clinical predictors for S-MEM. Conclusion: 21.5% of elderly Africans had subclinical abnormalities in their middle ear functioning, mostly with type AS tym-panogram. Independent clinical predictors of S-MEM included previous head injury, diabetes, history of osteoarthritis of knee joints, and absent acoustic reflex.