Sensorineural hearing loss in chronic otitis media

Abstract

In individuals with chronic otitis media-(COM), mixed hearing impairments are common, but it is unclear whether the raised bone conduction thresholds are a reflection of the pathologic process affecting the middle ear resulting in conductive defect. Charts of 65 patients with unilateral chronic otitis media were reviewed. These were three groups: 1) simple COM 2) COM with granulation, 3) COM with cholesteatoma. In them, the amount of sensorineural hearing loss in the third group was 20.3 dB, which was greater than the other two groups for pure-tone average. The amount of air conduction hearing loss was 66.8 dB, also the highest. In addition, the amount of sensorineural hearing loss was greater than that of normal contralateral ears in all of three groups. These findings suggest that more severe middle ear disease may result in sensorineural hearing loss. Raised bone conduction thresholds in chronic otitis media are considerably more likely to reflect the Carhart effect, rather than disease damage to the inner ear. However, for the majority of subjects, the amount of sensorineural hearing loss was judged not to be clinically significant.