Yung-Chang Yen1, Charlene Lin2, Shih-Feng Weng3, Yung-Song Lin4. 1. Department of Nursing, Min Hwei College of Health Care Management, Tainan, Taiwan2Chi Mei Medical Center, Liou-Ying Campus, Tainan, Taiwan. 2. Department of Molecular and Cell Biology, University of California, Berkeley. 3. Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan5Department of Hospital and Health Care Administration, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan. 4. Center for General Education, Southern Taiwan University of Science and Technology, Tainan, Taiwan7Department of Otolaryngology, Chi Mei Medical Center, Tainan, Taiwan.
Abstract
IMPORTANCE: Several sources have suggested an association between chronic sensory hearing impairment and chronic otitis media (COM). However, to our knowledge, no studies have evaluated the risk of sudden sensorineural hearing loss (SSNHL) in patients with COM (COM-positive). OBJECTIVE: To examine the risk of developing SSNHL in COM-positive patients. DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective cohort study; we compared 10 248 patients with newly diagnosed COM from January 1, 2001, through December 31, 2008, with 30 744 age- and sex-matched controls using data from Taiwan's National Health Insurance Research Database. METHODS: We followed each patient and evaluated the incidence of SSNHL. MAIN OUTCOMES AND MEASURES: The incidence of SSNHL at the end of 2011. RESULTS: The incidence of SSNHL was 3 times higher in the COM-positive cohort than in the COM-negative cohort (14.47 vs 4.83 per 10 000 person-years). Cox proportional hazard regressions showed that the adjusted hazard ratio (AHR) was 3.02 (95% CI, 2.30-3.98). A stratified analysis showed that the highest risk of developing SSNHL was in the first follow-up year (incidence rate ratio [IRR], 3.87; 95% CI, 1.93-7.79). Thereafter, the risk declined during years 1 to 5 and then peaked (IRR, 3.01; 95% CI, 1.89-4.79). Patients who needed surgery had a higher incidence of SSNHL (AHR, 2.69; 95% CI, 1.62-4.48) compared with patients who needed only medication and observation. CONCLUSIONS AND RELEVANCE: Chronic otitis media was significantly associated with a higher risk of developing SSNHL.
IMPORTANCE: Several sources have suggested an association between chronic sensory hearing impairment and chronic otitis media (COM). However, to our knowledge, no studies have evaluated the risk of sudden sensorineural hearing loss (SSNHL) in patients with COM (COM-positive). OBJECTIVE: To examine the risk of developing SSNHL in COM-positive patients. DESIGN, SETTING, AND PARTICIPANTS: This was a retrospective cohort study; we compared 10 248 patients with newly diagnosed COM from January 1, 2001, through December 31, 2008, with 30 744 age- and sex-matched controls using data from Taiwan's National Health Insurance Research Database. METHODS: We followed each patient and evaluated the incidence of SSNHL. MAIN OUTCOMES AND MEASURES: The incidence of SSNHL at the end of 2011. RESULTS: The incidence of SSNHL was 3 times higher in the COM-positive cohort than in the COM-negative cohort (14.47 vs 4.83 per 10 000 person-years). Cox proportional hazard regressions showed that the adjusted hazard ratio (AHR) was 3.02 (95% CI, 2.30-3.98). A stratified analysis showed that the highest risk of developing SSNHL was in the first follow-up year (incidence rate ratio [IRR], 3.87; 95% CI, 1.93-7.79). Thereafter, the risk declined during years 1 to 5 and then peaked (IRR, 3.01; 95% CI, 1.89-4.79). Patients who needed surgery had a higher incidence of SSNHL (AHR, 2.69; 95% CI, 1.62-4.48) compared with patients who needed only medication and observation. CONCLUSIONS AND RELEVANCE: Chronic otitis media was significantly associated with a higher risk of developing SSNHL.