Abstract Background and Objective: Chronic suppurative otitis media (CSOM) is a chronic inflammation of the middle ear and mastoid cavity that typically presents with recurrent otorrhea through a tympanic membrane perforation. Although conductive hearing loss is the most common type of hearing impairment associated with CSOM, a growing body of evidence points to the co-existence of sensorineural hearing loss (SNHL) in patients with long-standing CSOM. This study aimed to determine the incidence and severity of sensorineural hearing impairment among patients with CSOM and to analyze potential risk factors. Methods: A cross-sectional clinical study was conducted on 120 patients (180 ears) diagnosed with CSOM – both tubotympanic and atticoantral varieties – over 12 months at a tertiary care center. Detailed audiometric evaluations, including pure-tone audiometry and impedance audiometry, were performed. Patients with external confounding factors for SNHL were excluded. Statistical analyses were conducted to determine associations between demographic/clinical variables and the presence of SNHL. Results: Among 180 affected ears, 37 (20.6%) demonstrated a significant sensorineural component. Severity was observed to increase with the duration of CSOM, presence of cholesteatoma, and episodes of active discharge ( P < 0.05). The mean age of patients with SNHL was slightly higher than those without. The atticoantral variety showed a higher incidence of SNHL compared to the tubotympanic variety. Conclusion: Our findings highlight a notable incidence of SNHL in patients with CSOM, especially in those with prolonged disease and active discharge. A plausible pathophysiologic mechanism involves labyrinthitis, toxins, and inflammatory mediators breaching the cochlea. These findings align with multiple previous studies that identified a significant association between CSOM and sensorineural hearing deterioration. Meticulous disease control, timely intervention, and regular audiologic assessments are critical to preventing or mitigating cochlear damage.
Khan et al. (Tue,) studied this question.