INTRODUCTION
Common causes of conductive hearing loss are chronic middle ear diseases
(CMED), such as chronic otitis media (COM) with or without
cholesteatoma. Without adequate treatment, hearing loss can lead to
severely limited communication skills with a negative impact on
health-related quality of life (HRQoL).1 Furthermore,
CMED may severely affect HRQoL due to symptoms such as discharge from
the ear, otalgia and dizziness.2 Standardized
reporting of HRQoL, but also objective outcomes, such as hearing or
surgical techniques, is needed when establishing individual or new
therapeutic approaches, including new materials or prostheses as well as
novel surgical techniques.3 Concerning the evaluation
of surgical treatments of CMED, it has been shown that the outcome of
surgery is influenced by the structures involved into the disease, such
as the ossicles.4,5 It has to be assumed that
postoperative hearing improvement by reducing the air-bone gap is an
important but not the only factor influencing HRQoL.2Therefore, focusing on the audiological outcome as an objective
evaluation of the surgical success may lead to
misinterpretations.1 The assessment of HRQoL has
gained importance both in clinical studies and in clinical practice and
has become an important indicator for the assessment of therapeutic
success.6–12 Standardized questionnaires are used to
assess the individual impairment covering everyday situations,
communication or social contacts and accompanying symptoms such as
tinnitus.13,14 The Zurich Chronic Middle Ear Inventory
(ZCMEI-21) is a validated disease-specific tool for assessing
disease-specific symptoms of CMED and their impact on
HRQoL.6,10,15,16 The ZCMEI-21 features a complete
assessment of ear-related symptoms and a comprehensive survey of
psychosocial impairment.6 Recent clinical applications
of the ZCMEI-21 led to the assumption, that HRQoL varies among different
types of CMED.17,18 This may be explained by different
types of CMED presenting with differing severity of single symptoms such
as discharge, vertigo or hearing loss. This study therefore aimed to (i)
investigate characteristics of HRQoL and (ii) evaluate the association
between HRQoL and hearing among different types of CMED. Since not every
CMED necessarily is treated surgically, e.g. persistent mastoid cavities
without cholesteatoma or postinflammatory meatal fibrosis (PIMF), HRQoL
questionnaires may assist the counselling of the patients and find the
correct treatment.