Otologic diseases presentation and management among elderly patients in a tertiary health institution, South West Nigeria

Abstract

Background: Otologic diseases is one of the commonest presentation among elderly patients at the ear, nose and throat clinic worldwide.This study aimed at determining the prevalence, pattern, sociodemographic features, effect on quality of life and management of elderly patients with otologic diseases inEkiti state, Nigeria.
Materials and Methods: This was a cross sectional, prospective hospital based study of elderly patients with otologic diseases. The study was carried out in ear, nose and throat department of the study center over a period of 5 years. Data was taken using pretested interviewers assisted questionnaire. Data obtained were collated and statistically analyzed using SPSS version 18.0.
Results: The prevalence of otologic diseases in elderly patients was 5.3% of the patient population. Elderly male were 42.9% and male to female ratio was 1:1.5. Rural dwellers in 47.2% were less commoner than urban dwellers in 52 8%.Common otologic diseases in this study were 20.1% earwax impaction, 14.9% presbycusis, 9.9% otomycosis, 9.6% ototoxicity, 6.4% otitis externa and 6.1%benign paroxysmal positional vertigo. Bilateral otologic diseases was predominant in 55.1% than unilateral in 44.9%. Right otologic diseases accounted for 26.5%.Common clinical features among the elderly patients were hearing impairment in 57.4%, earache in 26.8%, ear discharge in 25.9%, earwax impaction in 25.4%, and aural blockage in 24.5%.Sensorineural hearing loss in 39.7% was commoner than conductive hearing loss and mixed hearing loss in 28.6% and 9.3% respectively. Type A, tympanometry (normal) was the commonest findings in 26.8%. Pure tone audiometry revealed 31.5% mild, 17.2% moderate and 12.5% moderate-severe hearing impairment.  Associated Comorbid illnesses were 31.2% sinonasal disorder, 22.7% throat diseases, 21.3% arthritis, 19.5% hypertension,13.4%, diabetes mellitus and 12.0% cardiopulmonary diseases. Common effect on quality of life in these elderly patients were 28.6% depression, 26.5% isolation, 25.9% embarrassment and 21.0% anxiety. Commonest mode of management were pre-hospital treatment in 62.4%, conservative/medical treatment in 50.7% and surgery/procedures in 47.4%.
Conclusion: Otologic diseases in elderly patients are common in our center. Common otologic diseases among these elderly patients were earwax impaction, presbycusis and otomycosis. These were associated with comorbid illnesses like arthritis, hypertension and diabetes mellitus. There was negative impact on the quality of life of the elderly patients.