Hearing loss assessment in primary and secondary acquired cholesteatoma<b><sup>,</sup></b>

Olsen, Julia Maria; Ribeiro, Fernando de Andrade Quintanilha; Yasui, Mariana Mieko Mendes; Santos, Ivan Taylor Ribeiro dos

doi:10.1016/j.bjorl.2014.11.009

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Brazilian Journal of Otorhinolaryngology

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ORIGINAL ARTICLES • Braz. j. otorhinolaryngol. 81 (6) • Nov-Dec 2015 • https://doi.org/10.1016/j.bjorl.2014.11.009 copy

Hearing loss assessment in primary and secondary acquired cholesteatoma^☆ 3 ☆Please cite this article as: Olsen JM, Ribeiro FAQ, Yasui MMM, dos Santos ITR. Hearing loss assessment in primary and secondary acquired cholesteatoma. Braz J Otorhinolaryngol. 2015;81:653-7. ^,^{^☆☆} ☆☆ Institution: Department of Otorhinolaryngology, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

INTRODUCTION:

Acquired middle ear cholesteatoma can be classified as primary or secondary. Although both can result in hearing loss, it is still controversial whether there is an association between the type of cholesteatoma and the degree of hearing loss.

OBJECTIVE:

To analyze the association between hearing loss and the type of acquired cholesteatoma, and the status of the ossicular chain.

METHODS:

This was a cross-sectional historical cohort study involving patients diagnosed with acquired cholesteatoma who were surgically treated. Air and bone conduction thresholds, air-bone gaps and the status of the ossicular chain were analyzed for both types of cholesteatoma.

RESULTS:

Eighty patients aged 5-57 were included in the study. Fifty-one patients had primary cholesteatoma and 29 had secondary cholesteatoma. Both types of cholesteatoma determined greater air-bone gaps at 0.5 kHz. Secondary cholesteatoma determined greater hearing loss in all analyzed frequencies and higher air conduction and air-bone gap means.

CONCLUSION:

There was association between hearing loss and the type of cholesteatoma. Secondary cholesteatoma resulted in greater hearing impairment.

Keywords:
Hearing loss; Cholesteatoma; Suppurative otitis media; Audiometry

Variable	Primary		Secondary		p
	n	%	n	%
Gender					0.187^a
Female	17	33.3	14	48.3	–
Male	34	66.7	15	51.7	–
Mean age	27.1	22.6^b	25.7	21.8^b	0.706^c
Total	51	63.8	29	36.2

Frequency	Primary		Secondary		p
	Mean	CI	Mean	CI
0.5 kHz	7.45	4.90–10.00	11.38	5.59–17.17	0.309
1 kHz	7.05	4.07–10.05	11.96	5.52–18.41	0.172
2 kHz	10.78	7.65–13.92	18.45	11.10–25.80	0.084
4 kHz	10.00	7.16–12.84	16.55	9.40–23.71	0.163

Frequency	Primary		Secondary		p
	Mean	CI	Mean	CI
0.5 kHz	40.29	35.46–45.13	50.52	41.92–59.12	0.029
1 kHz	38.43	33.23–43.62	50.71	42.03–59.39	0.008
2 kHz	33.83	29.12–38.53	50.86	40.51–61.21	0.002
4 kHz	23.40	23.51–39.22	50.34	40.27–60.42	0.038

Frequency	Primary		Secondary		p
	Mean	CI	Mean	CI
0.5 kHz	32.84	28.50–37.18	39.14	32.81–45.47	0.066
1 kHz	31.37	27.04–35.70	38.75	33.54–43.96	0.017
2 kHz	23.03	18.11–26.63	32.41	27.11–37.71	0.007
4 kHz	28.04	24.21–31.86	33.79	28.28–39.31	0.055

Threshold	Primary		Secondary		p
	Mean	CI	Mean	CI
Bone	8.8	6.4–11.2	14.6	8.5–20.7	0.136
Air	37.6	33.4–41.9	50.6	42.0–59.2	0.006
Gap	28.8	25.2–32.5	36.0	31.3–40.7	0.019

Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Sede da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico Facial, Av. Indianópolia, 1287, 04063-002 São Paulo/SP Brasil, Tel.: (0xx11) 5053-7500, Fax: (0xx11) 5053-7512 - São Paulo - SP - Brazil
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[1] * Corresponding author. E-mail:juolsen@hotmail.com (J.M. Olsen).