Hearing Impairment in Children and Adults With Acquired Middle Ear Cholesteatoma

OBJECTIVE: Evaluate hearing impairment in acquired middle ear cholesteatoma and investigate audiometric differences between children and adults. STUDY DESIGN: Cross-sectional comparative study. SETTING: Tertiary hospital. PATIENTS: Three hundred twenty-three consecutive patients diagnosed as having acquired middle ear cholesteatoma in at least one ear (385 ears) between August 2000 and March 2013 and no surgical history (mean [standard deviation {SD}] age, 32.8 [19.4] yr; 54.3% men and 34.8% children). INTERVENTION: Pure-tone audiometry. MAIN OUTCOME MEASURES: Air-conduction (AC) and bone conduction (BC) thresholds and air-bone gaps (ABGs) measured at the pure-tone average (PTA) and individual frequencies. RESULTS: The mean (SD) AC and BC thresholds at the PTA were 46.8 (22.7) and 17.7 (17.5) dB, respectively. The mean (SD) ABG at the PTA was 29.6 (13.4) dB, and that at 500 Hz was significantly greater than the ABGs at the other frequencies. Only 3.6% of the ears had profound hearing loss, without a significant difference between children and adults. The AC and BC thresholds were significantly greater in adults at all the frequencies (p ≤ 0.05), but the ABGs were not significantly different between the age groups. CONCLUSION: Acquired middle ear cholesteatoma is associated with significant hearing impairment, although profound hearing loss is rare. Adults have greater AC and BC thresholds than those in children but similar ABGs to children.