| Abstract [eng] |
Summary Background and objective Otosclerosis, or otospongiosis, is a condition of stapes fixation due to irregular spongy bone formation. The condition has an association with hearing disability which may lead to deficits in communication as well as social and psychological limitations. Preferred treatment choices are stapedotomy or stapedectomy together with prosthesis placement. Patient’s subjective evaluation of the treatment outcome, health-related quality of life (HRQoL), has recently been receiving more attention. In the field of otorhinolaryngology, otology specific survey, EOS-16, has been recently developed and a positive correlation has been observed between EOS-16 and a generic HRQoL survey, 15D. The objective of this thesis is to investigate if the health-related quality of life persists one, five and ten years after otosclerosis surgery. The objectives are evaluated by comparing otology specific and generic HRQoL surveys (EOS-16 and 15D) together with objective audiograms. Methods Data collection was based on the patient records at the Department of Otorhinolaryngology in Helsinki University Hospital. The data collection provided 339 patients in total from which 293 patients fulfilled the inclusion criteria. The surveys were sent in two cycles to ensure the maximum number of participants. During the first survey period from all 293 included patients 143 (48,8 %) replied. 150 patients received a second cycle of surveys and from those 36 patients (12,3 %) replied, meaning that total response rate was 179 (61,1 %). From all patients included into the research, 114 patients (38,9 %) did not reply before the deadline. Audiograms of all 179 patients were searched automatically from the hospitals data base. 161 patients (89,9 %) had their audiograms present in the systems and files and from those 123 (76,4 %) had both pre- and postoperative audiograms, 33 (20,5 %) had only postoperative and 5 (3,1 %) had only preoperative audiogram available. The Pre- and postoperative audiograms were most prevalent among one-year postoperative patients, 55 audiograms (44,7 %), second most among 5 years postoperative patients, 49 audiograms (39,9 %), and the least among 10 years postoperative patients, 19 audiograms (15,4 %). Results The analysis included evaluation of EOS-16 and 15D scores, pre- and postoperative pure-tone averages (PTA) as well as change in pure-tone average. When comparing aforementioned parameters together with one-, five- and ten-year follow-up groups, no statistically significant differences were observed. EOS-16 scores did correlate well with the audiometric outcomes, while from all parameters pure-tone average after surgery was the single best predictor of good health related quality of life. Burden caused by tinnitus had no correlation with audiometric results. Conclusions Otosclerosis can present in relatively young age and cause significant burden for the patient suffering from it. The individuals living with the disease and its consequences for many years, may experience not only hearing impairment and tinnitus but also deficits in communication as well as social and psychological limitations. The result of persisting quality of life ten years after otosclerosis surgery, evaluated by both otology specific and generic health-related quality of life surveys and audiometric parameters, is clinically significant. EOS-16 is a useful instrument in determining the impact of interventions in otologic patients. |
