Factors associated with quality of life after ear surgery in patients with chronic otitis media

摘要

Objective: To assess the factors affecting health-related quality of life (HRQOL) after ear surgery in patients with chronic otitis media (COM). Design: Prospective questionnaire-based outcome study. Setting: Tertiary care institution. Patients: The study population comprised 205 patients aged 21 to 67 years referred for ear surgery owing to COM with or without cholesteatoma between November 2009 and March 2011. Interventions: The ear surgery for COM included tympanoplasty, with or without mastoidectomy. The Korean version of the Chronic Ear Survey (K-CES), a disease-specific outcome survey, was administered before and 12 months after surgery. Main Outcome Measures: The primary outcome measures were the total score and subscale score, including an activity restriction-based subscale, symptom subscale, and medical resource utilization subscale. The scores were analyzed with disease- and patient-related factors affecting health-related quality of life. Results: Of the 205 patients enrolled, complete data from 156 patients were available for this study. The K-CES score in patients with COM improved after ear surgery in total and in all subscales of the K-CES (P < .001). In univariable analysis, poor improvement in total K-CES score was more likely to occur after ear surgery in patients with postoperative complications, diabetes mellitus, hearing loss as a chief complaint, lower air conduction threshold in postoperative audiometry, and a high level of education and in those who underwent canal wall down mastoidectomy (P < .05). Multivariable analysis using multiple linear regression revealed that the occurrence of complications, presence of diabetes mellitus, level of education, and postoperative air conduction thresholds were independent factors for poor improvement in total K-CES score (P < .05). Conclusion: Recognition of factors that have significant relation with subjective outcomes may help surgeons to identify patients who are prone to have a lower satisfaction and provide useful information in preoperative counseling.