Post-operative Sensorineural Hearing Loss After Middle Ear Surgery

Area of Science:

• Otolaryngology
• Neurosurgery
• Audiology

Background:

• Chronic suppurative otitis media (CSOM) management frequently involves tympanomastoid surgery, which can include mastoid drilling.
• Sensorineural hearing loss is a potential complication following middle ear surgeries.

Purpose of the Study:

• To compare pre-operative and post-operative bone conduction thresholds in patients undergoing middle ear surgeries.
• To identify risk factors and patient groups susceptible to hearing loss after tympanomastoid procedures.

Main Methods:

• A cohort of 90 patients undergoing tympanoplasty, modified intact canal wall mastoidectomy with tympanoplasty type-I, or modified radical mastoidectomy were analyzed.
• Demographic data, surgical duration, ossicular status, and drilling time were reviewed.
• Pre-operative and 3-4 month post-operative bone conduction thresholds were statistically compared.

Main Results:

• The average pre-operative hearing loss was 43.78 ± 14.22 dB.
• While mean air conduction thresholds improved post-operatively, six patients experienced hearing deterioration.
• Three patients (two from modified radical mastoidectomy group, one from modified intact canal wall mastoidectomy group) showed post-operative bone conduction worsening (13.75-21.5 dB).

Conclusions:

• Significant hearing loss, particularly affecting bone conduction, can occur in a subset of patients following tympanomastoid surgery.
• Individual patient outcomes, especially those showing hearing deterioration, require careful evaluation beyond average results.
• Identifying patients at risk for hearing loss is crucial for informed surgical decision-making and post-operative care.