Clinical Characteristics of Bilateral Chronic Otitis Media / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: The purpose of this study was to determine the prevalence of bilateral chronic otitis media (BCOM) and the ratio of unilateral or bilateral cholesteatoma in BCOM. Pre- and post-operative hearing were analyzed to see if bilateral balanced hearing were achieved. SUBJECTS AND METHOD: A retrospective review was done with a computerized otologic database to identify all patients who underwent surgical treatments for COM between 1998 and 2011, and has a follow up duration for at least 6 months. Comparative analysis between pre- and post-operation hearing was measured by pure tone audiometry and achievement of bilateral balanced hearing was analyzed with 'The Belfast rule of thumb'. RESULTS: Two hundred and eighty-one (14.5%) of 1938 patients suffered from BCOM, and of these, 73 (25.9%) of the patients with BCOM had cholesteatomas in one (12.4%) or both ears (13.5%). When a patient with BCOM is found with cholesteatoma in one ear, the odds of there being cholesteatoma in the other ear was 52.1%. According to 'The Belfast rule of thumb', it is considered difficult to achieve successful bilateral hearing gains sufficient for the patients to perceive subjective hearing improvements in BCOM. CONCLUSION: Approximately 15% of the COM patients were found with the disease in both ears, and the odds of a patient with BCOM having cholesteatoma in one ear also having cholesteatoma in the other ear was 53.4%. It was difficult to achieve subjective, successful and balanced bilateral hearing gain with three-dimensional hearing improvements.