To assess the postoperative quality of life (QoL) of patients operated on for chronic otitis media (COM) and cholesteatoma by endoscopic approach, with respect to disease-specific complaints and psychological distress, using two validated questionnaires: Chronic Ear Survey (CES) and Depression Anxiety Stress Scale-21 (DASS-21).
Eighty-five consecutive patients operated on for cholesteatoma and COM by endoscopic tympanoplasty from March 2018 to February 2020 filled in CES and DASS-21, within one month prior to surgery. A second administration of each questionnaire was performed at the yearly postoperative evaluation. A multivariate analysis using a linear regression model was performed to evaluate the role of the different variables associated with the questionnaires’ subscales and overall scores.
A significant improvement was achieved in all CES and DASS-21 subscales after endoscopic tympanoplasty. No patient showed a DASS-21 score compatible with a psychological distress both at the pre- and postoperative assessments. At multivariate analysis, the only significant factors associated with postoperative improvement in CES scores were preoperative DASS-21 “depression” score and months of follow-up.
Endoscopic tympanoplasty shows significantly improved QoL as assessed by disease-specific and psycho-emotional questionnaires. A subjective favourable effect of fully endoscopic ear surgery was demonstrated.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
the data that support the findings of this study are available from the corresponding author upon reasonable request.
Quaranta N, Iannuzzi L, Petrone P, D’Elia A, Quaranta A (2014) Quality of life after cholesteatoma surgery: intact-canal wall tympanoplasty versus canal wall-down tympanoplasty with mastoid obliteration. Ann Otol Rhinol Laryngol 123(2):89–93. https://doi.org/10.1177/0003489414523562
Lucidi D, De Corso E, Paludetti G, Sergi B (2019) Quality of life and functional results in canal wall down vs. canal wall up mastoidectomy. Acta Otorhinolaryngol Ital 39(1):53–60. https://doi.org/10.14639/0392-100X-2005
Bernardeschi D, Pyatigorskaya N, Russo FY, De Seta D, Corallo G, Ferrary E, Nguyen Y, Sterkers O (2017) Anatomical, functional and quality-of-life results for mastoid and epitympanic obliteration with bioactive glass s53p4: a prospective clinical study. Clin Otolaryngol 42(2):387–396. https://doi.org/10.1111/coa.12748
Taneja V, Milner TD, Iyer A (2020) Endoscopic ear surgery: does it have an impact on quality of life? Our experience of 152 cases. Clin Otolaryngol 45(1):126–129. https://doi.org/10.1111/coa.13459
Tarabichi M (2000) Endoscopic management of cholesteatoma: long-term results. Otolaryngol Head Neck Surg 122(6):874–881. https://doi.org/10.1016/S0194-59980070017-9
Marchioni D, Villari D, Mattioli F, Alicandri-Ciufelli M, Piccinini A, Presutti L (2013) Endoscopic management of attic cholesteatoma: a single-institution experience. Otolaryngol Clin N Am 46(2):201–209. https://doi.org/10.1016/j.otc.2012.10.004
Presutti L, Gioacchini FM, Alicandri-Ciufelli M, Villari D, Marchioni D (2014) Results of endoscopic middle ear surgery for cholesteatoma treatment: a systematic review. Acta Otorhinolaryngol Ital 34(3):153–157
Anschuetz L, Alicandri-Ciufelli M, Bonali M, Fermi M, Caversaccio M, Presutti L, Marchioni D (2018) Novel surgical and radiologic classification of the subtympanic sinus: implications for endoscopic ear surgery. Otolaryngol Head Neck Surg 159(6):194599818787180. https://doi.org/10.1177/0194599818787180
Lucidi D, Fernandez IJ, Botti C, Amorosa L, Alicandri-Ciufelli M, Villari D, Presutti L (2020) Does microscopic experience influence learning curve in endoscopic ear surgery? A multicentric study. Auris Nasus Larynx S0385–8146(20):30157–30167. https://doi.org/10.1016/j.anl.2020.06.015
Lailach S, Langanke T, Zahnert T, Garthus-Niegel S, Neudert M (2020) Impact of depressive disorders on quality of life after middle ear surgery in patients with chronic otitis media. Eur Arch Otorhinolaryngol. https://doi.org/10.1007/s00405-020-06397-7.Advanceonlinepublication.10.1007/s00405-020-06397-7
Marchioni D, Alicandri-Ciufelli M, Molteni G, Artioli FL, Genovese E, Presutti L (2010) Selective epitympanic dysventilation syndrome. Laryngoscope 120(5):1028–1033. https://doi.org/10.1002/lary.20841
Marchioni D, Mattioli F, Alicandri-Ciufelli M, Presutti L (2013) Prevalence of ventilation blockages in patients affected by attic pathology: a case–control study. Laryngoscope 123(11):2845–2853. https://doi.org/10.1002/lary.24165
Marchioni D, Villari D, Alicandri-Ciufelli M, Piccinini A, Presutti L (2011) Endoscopic open technique in patients with middle ear cholesteatoma. Eur Arch Otorhinolaryngol 268(11):1557–1563. https://doi.org/10.1007/s00405-011-1533-y
Nadol JB Jr, Staecker H, Gliklich RE (2000) Outcomes assessment for chronic otitis media: the Chronic Ear Survey. Laryngoscope 110(3 Pt 3):32–35. https://doi.org/10.1097/00005537-200003002-00009
Ralli G, Milella C, Ralli M, Fusconi M, La Torre G (2017) Quality of life measurements for patients with chronic suppurative otitis media: Italian adaptation of “Chronic Ear Survey.” Acta Otorhinolaryngol Ital 37(1):51–57. https://doi.org/10.14639/0392-100X-1041
Bottesi G, Ghisi M, Altoè G, Conforti E, Melli G, Sica C (2015) The Italian version of the Depression Anxiety Stress Scales-21: factor structure and psychometric properties on community and clinical samples. Compr Psychiatry 60:170–181. https://doi.org/10.1016/j.comppsych.2015.04.005
Wang PC, Nadol JB Jr, Merchant S, Austin E, Gliklich RE (2000) Validation of outcomes survey for adults with chronic suppurative otitis media. Ann Otol rhinol Laryngol 109(3):249–254. https://doi.org/10.1177/000348940010900302
Lailach S, Kemper M, Lasurashvili N, Beleites T, Zahnert T, Neudert M (2015) Health-related quality of life measurement after cholesteatoma surgery: comparison of three different surgical techniques. Eur Arch Otorhinolaryngol 272(11):3177–3185. https://doi.org/10.1007/s00405-014-3370-2
Yamamoto Y, Takahashi K, Morita Y, Ohshima S, Takahashi S (2014) Long-term follow-up results of canal wall down tympanoplasty with mastoid obliteration using the bone pate plate for canal wall reconstruction in cholesteatoma surgery. Otol Neurotol 35(6):961–965. https://doi.org/10.1097/MAO.0000000000000414
Bernardeschi D, Nguyen Y, Russo FY, Mosnier I, Ferrary E, Sterkers O (2015) Cutaneous and labyrinthine tolerance of bioactive glass S53P4 in mastoid and epitympanic obliteration surgery: prospective clinical study. Biomed Res Int 2015:242319. https://doi.org/10.1155/2015/242319
Jung KH, Cho YS, Hong SH, Chung WH, Lee GJ, Hong SD (2010) Quality-of-life assessment after primary and revision ear surgery using the chronic ear survey. Arch Otolaryngol Head Neck Surg 136(4):358–365. https://doi.org/10.1001/archoto.2010.24
Bakir S, Kinis V, Bez Y, Gun R, Yorgancilar E, Ozbay M, Aguloglu B, Meric F (2013) Mental health and quality of life in patients with chronic otitis media. Eur Arch Oto-Rhino-Laryngol 270(2):521–526. https://doi.org/10.1007/s00405-012-2031-6
Harris AB, Marrache M, Puvanesarajah V, Raad M, Jain A, Kebaish KM, Riley LH, Skolasky RL (2020) Are preoperative depression and anxiety associated with patient-reported outcomes, health care payments, and opioid use after anterior discectomy and fusion? Spine 20(8):1167–1175. https://doi.org/10.1016/j.spinee.2020.03.004
Lovibond SH, Lovibond PF, Psychology Foundation of Australia (1995) Manual for the depression anxiety stress scales. Psychology Foundation of Australia, Sydney
Baumann I, Gerendas B, Plinkert PK, Praetorius M (2011) General and disease-specific quality of life in patients with chronic suppurative otitis media–a prospective study. Health Qual Life Outcomes 9:48. https://doi.org/10.1186/1477-7525-9-48
Conflict of interest
All the authors declare no conflicts of interest.
Comitato Etico AVEN, ID 0019114/19.
Consent to participate
All patients received appropriate and comprehensible information about the surgical procedures and tests and gave their written consent.
Consent for publication
All the authors give their consent for publication.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Lucidi, D., Reale, M., Fermi, M. et al. Disease-specific quality of life and psychological distress after endoscopic tympanoplasty. Eur Arch Otorhinolaryngol (2021). https://doi.org/10.1007/s00405-021-06670-3
- Quality of life
- Chronic ear survey
- Depression anxiety stress scale
- Endoscopic ear surgery