Analysis of comorbid psychiatric disorders in patients with chronic otitis media associated tinnitus

Objective:To analyze the distribution of comorbid psychiatric disorders in patients with chronic otitis media associated tinnitus. Method:The data of patients with chronic otitis media associated tinnitus who accepted surgical treatments from July 2017 to September 2018 were retrospectively analyzed. All patients accepted pure tone audiometry and acoustic conductance examination and were requested to fill the tinnitus history questionnaire, THI, TEQ, SAS, SDS and PSQI scales before operation. When the SAS or/and SDS score ≥50 the patient was judged as having comorbid psychiatric disorders. When the PSQI score>6 the patient was judged as having comorbid sleep disorder, and then all the results were analyzed. Result:Sixty-two patients were included in the study, 43 cases were diagnosed as chronic suppurative otitis media, and 19 cases were diagnosed as middle ear cholesteatoma. The average course of chronic otitis media or middle ear cholesteatoma was（14.38±14.06） years, while the average course of tinnitus was（8.39±11.69） years. There were 32 cases with mild to moderate tinnitus（gradeⅠ-Ⅱ）（51.61%） and 30 cases with moderate to severe tinnitus（grade Ⅲ-Ⅴ）（48.39%）. Before operation, there were 4 cases（6.45%） with normal hearing, 38 cases（61.29%） with conductive hearing loss, and 20 cases（32.36%） with mixed hearing loss. There was no significant difference in tinnitus severity between different hearing loss degrees and types（P>0.05）. The average SAS score was 45.10±11.61, and the average SDS score was 43.48±14.67, both higher than the normal modulus（30 points）, among which 27 cases（44.00%） comorbid psychiatric disorders. The THI score in patients with comorbid psychiatric disorders（57.85±21.1） was significantly higher than that in patients without comorbid psychiatric disorders（29.2±17.39）（P<0.05）. The PSQI score in patients with comorbid psychiatric disorders（8.86±3.47） was significantly higher than that of those without comorbid psychiatric disorders（6.24±2.54）（P<0.05）. Fifty-three patients were followed up for 0.5 to 1.8 years after operation, and in 43 cases the tinnitus was reduced or disappeared after operation（the effective rate was 81.13%）. There were no significant difference between patients in tinnitus relief group and those in tinnitus without relief group in age, sex, course of the disease, type of the disease, with or without comorbid psychiatric disorders and/or sleep disorder, postoperative hearing improvement. Conclusion:Comorbid psychiatric disorders are common in patients with chronic otitis media associated tinnitus and the tinnitus in patients with comorbid psychiatric disorders is significantly more serious than that those without. For the treatment of chronic otitis media associated tinnitus, besides surgery, the complications such as psychiatric and sleep disorders and so on should be evaluated and treated accordingly.