Predictors of cochlear involvement in patients with mucosal type of chronic otitis media: a cross-sectional analysis

Abstract Background Chronic otitis media (COM) is one of the leading causes of hearing impairment worldwide, mostly presenting with conductive hearing loss. However, some studies suggest the presence of associated sensorineural hearing loss due to cochlear involvement in a significant proportion of cases. The aim of our study was to analyze the factors associated with the development of sensorineural hearing loss (SNHL) in patients with the mucosal type of COM. Materials and methods Patients with unilateral inactive COM (mucosal type) were identified, and pure tone audiometry was done to find those with sensorineural or mixed hearing loss. A detailed history was taken to document demographic characteristics and various parameters, including duration of disease, tinnitus, frequency of active discharge, and any prior usage of ototoxic ear drops, along with a thorough clinical examination. Results One hundred twenty patients were recruited for the study. Both perforation size and disease duration were significant independent predictors of hearing impairment in the current study population and showed significantly higher odds of worsening the impairment. Duration of tinnitus and frequency of discharge demonstrated high collinearity with disease duration, indicating their dependence on the former. The statistical association was strong for the frequency of otorrhea, while the presence of complications demonstrated a moderate association. Correlation analyses revealed a monotonic, positive, and moderately strong relationship between hearing impairment and size of perforation (Spearman’s ρ = 0.581, 0.3 < ρ < 0.7), overall disease duration (ρ = 0.689), and duration of tinnitus (ρ = 0.378), suggesting a unidirectional worsening of hearing in larger perforations and with prolonged suffering. Conclusion A number of individual parameters were found to be associated with the development of SNHL and mixed hearing impairment in patients with the mucosal type of COM. The identification of these factors may therefore help to predict the risk of progression to mixed hearing loss. Early detection of the disease and prompt initiation of treatment may prove to be beneficial to avoid the same.