Diagnostics, therapy and prognosis of acute otitis media with toxic inner ear disorder

Background A complication of acute otitis media (AOM) is the toxic inner ear disorder (IED) with sensorineural hearing loss (SNHL). The therapy includes corticosteroids, antibiotics as well as drainage of middle ear effusion and is not standardized yet. The aim of this work is to analyze the effectiveness of different treatment regimens and to identify prognostic factors for recovery of the inner ear function.

Methods This retrospective study included patients with unilateral AOM with toxic IED who were treated as inpatients at the Otolaryngology-Department Charité Berlin, Camus Benjamin Franklin between 01/2014 - 06/2022. Data about clinical presentation, pre- and post-therapeutic hearing thresholds, treatment and presence of restitutio ad integrum were gathered. The pure tone average (PTA) across the frequencies 0.5; 1; 2 and 4 kHz was calculated.

Results 160 patients were included (64.4% women, 35.6% men) with a mean age of 44 years. The mean threshold level was 23.75 dB for the affected ear and 10 dB for the healthy ear. Corticosteroids and antibiotics were given>93% and a myringotomy with or without tube placement was done in 85% of the patients. A long-term pure tone audiogram was available as follow-up for 62 patients (up to 8 years). 55 patients (88.7%) recovered completely after 18 days, four (6.5%) showed partly remission and in three patients (4.8%) there was no remission at all. The start of therapy, the initial severity of hearing impairment, the type of treatment and other associated characteristics are analyzed by using regression models to identify prognostic factors for the course of the disease.

Conclusions Most patients with AOM with IED recover without remaining SNHL when appropriate treatment is administered in time.

 

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Artikel online veröffentlicht:
19. April 2024