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慢性中耳炎手術後生活品質進步之研究

Improvement in Quality of Life Following Surgery for Chronic Otitis Media

摘要


BACKGROUND: Despite the prevalence of chronic otitis media, only a limited number of studies have investigated the improvement in quality of life following ear surgery for this disease. Thus, the aim of this study was to evaluate changes in disease-specific health status and improvements in quality of life following surgical intervention. MATERIALS AND METHODS: A total of 77 adults with unilateral chronic otitis media were consecutively and prospectively enrolled in the study, with demographic data collected prior to surgery. All patients were evaluated using a validated Chinese version of the Chronic Ear Survey (CES), before and one year after tympano-mastoid surgery. Patients were categorized into dry ear and wet ear groups for comparisons. The paired t-test was used to compare pre- and post-operative CES scores. Additionally, effect size was used to estimate the magnitude of the improvement in quality of life, with stepwise multiple linear regression models utilized for factor analysis and Cronbach's alpha for evaluation of internal consistency of all CES data. RESULTS: Following ear surgery, significant improvements were demonstrated for activity restriction, symptom and, medical resource utilization CES subscores, and total CES scores for all patients (p<0.0001). The effect size for the CES improvement for the wet ear group was greater than for the dry ear analog, however the former still had better post-operative health status. Diagnostic category was the most important outcome predictor (p<0.05, R2=0.55). CONCLUSION: This study provides evidence of the subjective outcome following middle ear surgery for chronic otitis media. It appears that successful surgical intervention is effective for improvement of disease-specific quality of life. In our study, the effect was particularly significant for patients who had suffered from intractable middle ear infection. Analysis of the quantitative data provided by this study confirms our clinical experience.

並列摘要


BACKGROUND: Despite the prevalence of chronic otitis media, only a limited number of studies have investigated the improvement in quality of life following ear surgery for this disease. Thus, the aim of this study was to evaluate changes in disease-specific health status and improvements in quality of life following surgical intervention. MATERIALS AND METHODS: A total of 77 adults with unilateral chronic otitis media were consecutively and prospectively enrolled in the study, with demographic data collected prior to surgery. All patients were evaluated using a validated Chinese version of the Chronic Ear Survey (CES), before and one year after tympano-mastoid surgery. Patients were categorized into dry ear and wet ear groups for comparisons. The paired t-test was used to compare pre- and post-operative CES scores. Additionally, effect size was used to estimate the magnitude of the improvement in quality of life, with stepwise multiple linear regression models utilized for factor analysis and Cronbach's alpha for evaluation of internal consistency of all CES data. RESULTS: Following ear surgery, significant improvements were demonstrated for activity restriction, symptom and, medical resource utilization CES subscores, and total CES scores for all patients (p<0.0001). The effect size for the CES improvement for the wet ear group was greater than for the dry ear analog, however the former still had better post-operative health status. Diagnostic category was the most important outcome predictor (p<0.05, R2=0.55). CONCLUSION: This study provides evidence of the subjective outcome following middle ear surgery for chronic otitis media. It appears that successful surgical intervention is effective for improvement of disease-specific quality of life. In our study, the effect was particularly significant for patients who had suffered from intractable middle ear infection. Analysis of the quantitative data provided by this study confirms our clinical experience.

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