Long-Term Health Utilization and Outcomes in Chronic Suppurative Otitis Media. (August 2022)

• Record Type: Journal Article
• Authors: Thai, Anthony; Aaron, Ksenia A.; Kaufman, Adam C.; Santa Maria, Peter L.
• Is Part Of: Otolaryngology--head and neck surgery. Volume 167:Number 2(2022)
• Page Start: 341
• Page End: 349
• Publication Date: 2022-08
• Subjects: chronic suppurative otitis media -- health utilization -- medical management -- tympanoplasty -- tympanomastoidectomy -- sensorineural hearing loss; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/01945998211050626
• Languages: English
• ISSNs: 0194-5998

Abstract

Objective: To report health utilization patterns and outcomes of medical and surgical management in patients with chronic suppurative otitis media (CSOM). Study Design: Retrospective cohort. Setting: Academic otology clinic. Methods: This study included 175 patients with CSOM with a first clinic visit at our institution between March 2011 and November 2016. All patients displayed a diagnosis of CSOM by International Classification of Diseases code, had at least 1 episode of active CSOM (defined as perforation with otorrhea), and had a documented history of chronic ear infections. The mean age was 49.5 ± 1.5 years, 53% were female, and mean follow-up time was 3.5 ± 0.3 years. Results: Patients had an average of 9.5 ± 0.5 otology visits, 4.7 ± 0.4 prescriptions, and 1.7 ± 0.1 surgeries, with estimated per patient cost ranging from $3927 to $20, 776. Under medical management, 69% of patients displayed recurrence of disease, with a median time to recurrence of 4 months. For tympanoplasty and tympanomastoidectomy, median time to recurrence was similar at 5 and 7 years, respectively ( P = .73). At the most recent visit, the prevalence of all patients with CSOM displaying moderate or worse sensorineural hearing loss (SNHL) was 41%. Conclusions: CSOM represents a major public health issue with high health care utilization and associated costs. Surgery is superior to medical therapy for achieving short- to medium-term inactive disease. Patients with CSOM display a high SNHL burden.