[The sensorineural component of hearing loss associated with cholesteatoma]

Patients with cholesteatoma often suffer neurosensorial hearing loss with variable bone conduction thresholds. Its origin is debated and has been attributed to the ototoxicity of topical drugs, immune reactions, effects of ototoxic antibiotics applied to the ear, etc. A selected series of 50 patients who underwent surgery for chronic ear disease due to cholesteatoma in our ENT department were studied to evaluate the possible origin of the bone conduction component of hearing loss. Different clinical, audiological, and surgical aspects were analyzed, including cholesteatoma site and extension, age, sex, evolution of the symptoms, pure tone audiometry data, middle ear involvement, the operation performed, and the occurrence of complications. Bone conduction thresholds were reported as pure tone differential thresholds (affected vs non-affected ear). A specific cholesteatoma-related neurosensorial hearing loss was observed that might lead to irreversible hearing loss. Neurosensorial involvement seems to be related mainly to the duration of symptoms, type of surgery, certain specific clinical aspects, and complications.