Long-term outcomes of tympanoplasty with persistent air-bone gap in adults with chronic otitis media: hearing, health care utilization and quality of life.

Purpose: To evaluate long-term hearing outcomes, healthcare utilization, and health-related quality of life (HRQoL) in adults with chronic otitis media (COM) who underwent primary tympanoplasty (PT) but were left with a significant air-bone gap (25-30 dB).

Methods: A retrospective medical chart review was conducted to assess the standard of care for COM patients across three European countries, analyzing hearing data, healthcare utilization, and demographics. Additionally, HRQoL and hearing disability were assessed prospectively using questionnaires. Sixty-nine adults diagnosed with COM who underwent PT between 2010 and 2016 were included.

Results: Average hearing outcomes showed minimal to no improvement, with a substantial number of patients experiencing moderate to severe hearing loss post-PT. Many continued to rely on rehabilitative technologies, with bone conduction hearing device (BCHD) users reporting higher consistent use compared to conventional hearing aid users. Participants required an average of 7.6 healthcare visits with a mean follow-up time of 7.64 years after PT, underscoring the ongoing burden on healthcare systems. Impaired hearing negatively impacted both general and disease-specific HRQoL.

Conclusion: Managing COM remains challenging due to the variability in surgical outcomes, particularly regarding hearing restoration. The high post-PT healthcare utilization and persistent HRQoL impairments caused by impaired hearing highlight the need for more effective rehabilitative strategies such as conventional hearing aids and BCHD.