Quality-of-life assessment after primary and revision ear surgery using the chronic ear survey

Abstract

Objective: To measure subjective outcomes after primary and revision surgery for chronic ear disease.

Design: Prospective questionnaire-based outcome study.

Setting: Tertiary referral center.

Patients: Adults with chronic otitis media with or without cholesteatoma.

Interventions: Primary or revision surgery for chronic ear disease.

Main outcome measures: The Chronic Ear Survey, a disease-specific outcome survey, was administered preoperatively and at 1 year after surgery. We analyzed the total score and the activity restriction, symptom, and medical resource utilization subscale scores. Scores were averaged on the basis of the number of questions included in each category. Differences in preoperative and postoperative scores were analyzed within and between the 2 groups. We also assessed audiometry, postoperative complications, and the clinical condition of the operated-on ear.

Results: Twenty-one patients were enrolled in the primary surgery group, and 20 were enrolled in the revision surgery group. Significant improvements in the total score and each subscale score were observed in both groups at the 1-year postoperative survey. Improvements in the total score and symptom subscale scores were greater in the primary surgery group than in the revision surgery group (P < .05). The air conduction thresholds and any postoperative clinical problems were correlated with the total score and subscale scores in the primary group but not in the revision surgery group.

Conclusion: Comparable objective outcomes are achieved after primary and revision surgery for chronic ear disease, but the improvement in quality of life is greater in the primary surgery group.