Bächinger David, Neudert Marcus, Dazert Stefan, Röösli Christof, Huber Alexander, Mlynski Robert, Weiss Nora M
Klinik für Hals‑, Nasen- und Ohrenheilkunde, St. Elisabeth-Hospital, Ruhr-Universität Bochum, Bochum, Deutschland.
Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum "Carl Gustav Carus", Dresden, Deutschland.
HNO. 2023 Sep;71(9):556-565. doi: 10.1007/s00106-023-01324-8. Epub 2023 Jul 8.
Chronic otitis media (COM) can lead to significant impairment of health-related quality of life (HRQoL) due to symptoms such as otorrhea, pain, hearing loss, tinnitus, or dizziness. A systematic assessment of HRQoL in COM is becoming increasingly important as it complements (semi-)objective outcome parameters in clinical practice and research. HRQoL is measured by means of patient-reported outcome measures (PROMs). There are two disease-specific validated PROMs available for COM in German-the Chronic Otitis Media Outcome Test (COMOT-15) and the Zurich Chronic Middle Ear Inventory (ZCMEI-21)-which have become increasingly popular in recent years.
The purpose of this narrative review is to present the current state of research on measuring HRQoL in COM before and after surgical procedures.
Hearing is the most important factor influencing HRQoL in COM. Surgical procedures usually result in a clinically relevant improvement in HRQoL in COM with or without cholesteatoma. However, if cholesteatoma is present, its extent does not correlate with HRQoL. While HRQoL plays a secondary role in establishment of the indication for surgical therapy in COM with cholesteatoma, it plays an important role in terms of relative surgical indications, e.g., a symptomatic open mastoid cavity after resection of the posterior canal wall. We encourage the regular use of disease-specific PROMs preoperatively as well as during follow-up to assess HRQoL in COM in individual patients, in research, and in the context of quality monitoring.
慢性中耳炎(COM)可因耳漏、疼痛、听力损失、耳鸣或头晕等症状导致健康相关生活质量(HRQoL)严重受损。随着其在临床实践和研究中补充(半)客观结局参数,对COM患者HRQoL的系统评估变得越来越重要。HRQoL通过患者报告结局测量(PROMs)来衡量。在德语中有两种针对COM的经过验证的特定疾病PROMs——慢性中耳炎结局测试(COMOT - 15)和苏黎世慢性中耳量表(ZCMEI - 21),近年来它们越来越受欢迎。
本叙述性综述的目的是介绍手术前后COM患者HRQoL测量的研究现状。
听力是影响COM患者HRQoL的最重要因素。手术通常会使伴有或不伴有胆脂瘤的COM患者的HRQoL在临床上得到显著改善。然而,如果存在胆脂瘤,其范围与HRQoL无关。虽然HRQoL在伴有胆脂瘤的COM手术治疗指征的确定中起次要作用,但在相对手术指征方面,如后鼓室壁切除术后有症状的开放乳突腔,它起着重要作用。我们鼓励在术前以及随访期间定期使用特定疾病的PROMs,以评估个体患者、研究以及质量监测背景下COM患者的HRQoL。