Hearing Recovery and Disease-Specific Quality of Life After Tympanoplasty for Safe-Type Chronic Otitis Media: A Prospective Longitudinal Cohort Study

Hearing Function and Quality of Life after Tympanoplasty

Abstract

Background: Tympanoplasty is the standard surgical treatment for safe-type chronic otitis media (COM), yet its impact on hearing recovery and patient-reported quality of life (QoL) requires further evaluation. This study investigated postoperative changes in hearing function and QoL and their association following tympanoplasty.

Methods: This prospective longitudinal cohort study included patients with safe-type COM who underwent tympanoplasty. Hearing function was assessed using pure-tone audiometry, and QoL was evaluated using the Chronic Otitis Media Questionnaire-12 (COMQ-12) before surgery and three months postoperatively. Paired t-test and Wilcoxon signed-rank test were used to compare pre- and postoperative outcomes. Spearman's correlation and multiple linear regression analyses were performed to evaluate the relationship between hearing outcomes and QoL.

Results: Mean pure-tone average improved significantly from 50.37 ± 16.10 dB preoperatively to 31.93 ± 16.06 dB postoperatively, with a mean hearing gain of 18.26 ± 10.77 dB (p<0.001). Median COMQ-12 scores significantly decreased from 32.0 (16.0–55.0) to 18.0 (0.0–40.0) (p<0.001), indicating improved QoL. Although postoperative hearing threshold independently predicted postoperative disease-specific quality of life, hearing gain showed no significant correlation with COMQ-12 improvement (r=-0.035, p=0.832). Multiple linear regression identified postoperative hearing threshold as an independent predictor of postoperative QoL.

Conclusion: Tympanoplasty improves hearing function and disease-specific quality of life in patients with safe-type chronic otitis media. Postoperative hearing status independently influences patient-reported quality of life, supporting the use of both audiometric and patient-reported outcome measures when evaluating surgical success.