Patients with chronic otitis media (COM) suffer from otorrhoea und hardness of hearing. Spreading over many years and frequently including mutiple surgeries, the course of disease restricts the quality of life of the affected patients. The impact of mental health on disease-spezific QoL has not been researched so far regarding the objectified ear symptoms.
100 patients with COM have been interviewed amongst applying the Chronic Otitis Media Outcome Test 15 (COMOT-15), Zurich Chronic Middle Ear Inventory (ZCMEI-21) and Patient Health Questionnaire (PHQ-D). That has occured preoperatively and 6 month after middle ear surgery. The objectification of the ear symptoms has been shown by pre- and postoperatively measured audiometry and by Ossiculoplasty Outcome Staging Index (OOPS-Index). In addition somatic diseases were quantified by Charlson Comorbidity Index. We calculated the impact of depressiveness on disease-specific QoL by multivariate regression analysis.
Preoperative depression symptoms were prospectively associated with a worse disease-specific QoL six months after the rehabilitating ear-surgery (COMOT-15 β= 0.45/ZCMEI-21 β= 0.61). This effect stayed statistically significant even after adjustment for the absolute hearing level, the extent of the middle ear pathology as well as the somatic comorbidities (COMOT-15 β= 0.41/ZCMEI-21 β= 0.56).
Patients with COM and increased depressiveness show a stronger impairment of disease-specific QoL after ear surgey. Therefore evaluation tools for acquisition of QoL and mental health sould be considered in clinical practice.
