Impact of Otologic Surgery on Medical and Social Outcomes in Adults With Hearing Loss.

Abstract

Objectives: To test the hypothesis that surgical otologic intervention for any type of adult hearing loss decreases the odds for incident adverse life events (ALEs) and medical comorbidities (MCBs).

Study design: Retrospective cohort database study.

Methods: Electronic medical record data from the TriNetX Research Network were queried for adults (age ≥18 years) with congenital, sensorineural, conductive, and mixed hearing loss (HL). Patients were further stratified into 3 groups by presence or absence (HL-surgery) of surgical intervention at any point following diagnosis, including (1) stapes surgery (HL + stapes); (2) cochlear implantation and bone-anchored hearing aid (HL + CI); and (3) mastoidectomy alone and tympanoplasty with or without mastoidectomy (HL + TM). Primary outcomes were defined as odds for new ALEs or MCBs at any point given HL treatment status [Odds ratio with 95% confidence interval, (OR; 95% CI, P-value)]. Cohorts were balanced using propensity-score matching (PSM) based on US census-defined demographics and congenital comorbidities.

Results: There were 2 577 153 patients included in this study. Matched analysis demonstrated that HL + stapes adults (n = 7985) had 0.37-lower odds (95% CI = 0.30-0.47, P < .0001) of experiencing any incident ALE versus HL-surgery adults (n = 2 518 409). Adults in the HL + CI cohort (n = 17 129) had 0.58-lower odds (0.52-0.66, P < .0001) of experiencing any incident MCB versus HL-surgery adults.

Conclusions: This study highlights the benefit of surgical intervention for adult hearing loss on social and medical phenomes. These findings represent the largest cohort study to date demonstrating this association and further support that hearing restoration improves patient socioeconomic and medical outcomes.