Long‐Term Health Utilization and Outcomes in Chronic Suppurative Otitis Media. (12th October 2021) - Thai, Anthony
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.