Article
Health-related quality of life in patients with chronic otitis media
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Published: | July 22, 2009 |
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Introduction: Relevance of health-related quality of life (HR-QOL) as an outcome parameter is steadily increasing. Until now no validated German measuring instrument for patients with chronic otitis media (COM) was applicable. In this study we developed and applied a new instrument for patients with COM.
Patients and methods: The alpha version of the Chronic Otitis Media Outcome Test with 31 Items (COMOT-31) was developed and a science-based item reduction by means of data from 50 patients was performed. The resultant questionnaire with 15 items (COMOT-15) was then validated. Changes of disease-specific HR-QOL were evaluated and correlated with audiometric findings in a prospective study with 90 patients. Furthermore, general HR-QOL data were collected with the Short Form 36 Health Survey (SF-36).
Results: Disease-specific HR-QOL in patients with COM was improved after tympanoplasty in all the scales of the COMOT-15. While there was no difference in HR-QOL assessment between patients with mesotympanal respectively epitympanal COM we found a worse outcome in patients who received revision surgery compared with those receiving primary surgery. Audiometric findings correlated very well with the subscale hearing function from the COMOT-15 questionnaire (r=0.41). General HR-QOL measured with the SF-36 was not significantly changed by tympanoplasty. However, general HR-QOL was significantly reduced pre- and postoperatively in dimension of mental health when compared with the normal German population.
Conclusion: Tympanoplasty lead to a significant improvement of disease-specific HR-QOL in patients with COM. Patients with revision surgery assessed the outcome worse compared with patients with primary surgery. Furthermore, no HR-QOL related difference were found between patients with mesotympanal versus epitympanal COM. General HR-QOL was not changed by the operation but is reduced in dimension of mental health when compared with the normal German population.