Long‐Term Health Utilization and Outcomes in Chronic Suppurative Otitis Media

Abstract

Objective To report health utilization patterns and outcomes of medical and surgical management in patients with chronic suppurative otitis media (CSOM). Study Design Retrospective cohort. Setting Academic otology clinic. Methods This study included 175 patients with CSOM with a first clinic visit at our institution between March 2011 and November 2016. All patients displayed a diagnosis of CSOM by International Classification of Diseases code, had at least 1 episode of active CSOM (defined as perforation with otorrhea), and had a documented history of chronic ear infections. The mean age was 49.5 ± 1.5 years, 53% were female, and mean follow-up time was 3.5 ± 0.3 years. Results Patients had an average of 9.5 ± 0.5 otology visits, 4.7 ± 0.4 prescriptions, and 1.7 ± 0.1 surgeries, with estimated per patient cost ranging from $3927 to $20,776. Under medical management, 69% of patients displayed recurrence of disease, with a median time to recurrence of 4 months. For tympanoplasty and tympanomastoidectomy, median time to recurrence was similar at 5 and 7 years, respectively ( P = .73). At the most recent visit, the prevalence of all patients with CSOM displaying moderate or worse sensorineural hearing loss (SNHL) was 41%. Conclusions CSOM represents a major public health issue with high health care utilization and associated costs. Surgery is superior to medical therapy for achieving short- to medium-term inactive disease. Patients with CSOM display a high SNHL burden.

Healthcare consumption among subjects with otitis media undergoing middle ear surgery—analysis of cost drivers

“…However, it should be noted that these data are collected from a Swedish patient register and will not be directly transferrable to other healthcare systems. A previous study has investigated healthcare utilization and prescribing patterns in patients with eustachian tube dysfunction [ 18 ] and, at the time of writing, a retrospective study investigating healthcare utilization in the USA also documented the high healthcare utilization and associated costs in patients with chronic otitis media [ 19 ].…”

Gold nanocluster adjuvant enables the eradication of persister cells by antibiotics and abolishes the emergence of resistance

“…4 Patients who fail medical therapy often undergo middle ear surgery, and only 50% are recurrence-free after five years. 3 The Food and Drug Administration (FDA) has approved fluoroquinolones for the treatment of CSOM due to their nonototoxic nature. However, current topical fluoroquinolone therapy fails to address this disease because it is ineffective against bacterial persister cells within biofilms.…”

“…1,2 It also has a significant cost burden in the first world, accounting for between 4 and 11 billion dollars in annual health care costs in the United States alone. 3 CSOM is usually treated with topical antibiotics or antiseptics, which successfully convert to temporary inactive disease but fail to remove the infection, making it prone to relapse. 4 Patients who fail medical therapy often undergo middle ear surgery, and only 50% are recurrence-free after five years.…”

Sociodemographic Factors and Health Care Utilization in Pediatric Chronic Suppurative Otitis Media

“…On average, CSOM requires 10 otology visits over 3.5 years with children having 2.6 times higher risk of recurrence of otologic symptoms or cholesteatoma. 14,15 Nonadherence to timely preoperative or postoperative care could negatively impact clinical symptoms or disease recurrence or progression.…”