The Secret Behind Restoring Hearing in an Ear That Had Been Deaf for More Than 20 Years [Health Check]

[Financial News] Patients with chronic otitis media who have left hearing loss untreated for more than 20 years can recover hearing to a level comparable to that of patients with ordinary sensorineural hearing loss through cochlear implant (CI) surgery, a study has found.
A research team led by Professor Park Hong-joo of the Department of Otorhinolaryngology at Asan Medical Center announced on the 10th that it had compared hearing outcomes after CI surgery in patients with acquired chronic otitis media and those with ordinary sensorineural hearing loss. One year after surgery, the two groups showed similarly strong auditory performance. In particular, the chronic otitis media group maintained stable word recognition scores without a decline, even after experiencing hearing loss for more than 20 years.
Otitis media is an inflammatory disease affecting the middle ear that can interfere with hearing and communication. When otitis media recurs over a long period, it can worsen into sensorineural hearing loss. If hearing loss persists, the cerebral cortex responsible for hearing, language acquisition, and speech production can shrink, potentially leading to cognitive decline and dementia.
When delayed treatment leaves patients at a stage where hearing aids can no longer significantly improve hearing, the remaining option is CI surgery. However, patients with chronic otitis media often have chronic inflammation or anatomical changes in the middle ear and mastoid cavity. This increases the risks of infection and electrode extrusion during surgery, so the procedure has been performed only on a limited basis.
The research team reduced these risks and effectively restored hearing by completely removing the inflammation, filling the middle-ear cavity with a fat graft, and then performing CI surgery. The team compared pre- and postoperative hearing and imaging results from 33 patients with acquired chronic otitis media who underwent CI surgery between July 2006 and July 2021 and 70 age- and sex-matched patients with noninflammatory sensorineural hearing loss.
One year after surgery, the chronic otitis media group showed overall auditory outcomes—including word recognition scores and pure-tone hearing thresholds—that were as strong as those of the ordinary sensorineural hearing loss group. The most notable finding was the difference in prognosis according to the duration of hearing loss.

In the ordinary sensorineural hearing loss group, word recognition scores tended to decline sharply after the duration of hearing loss exceeded 20 years. By contrast, the chronic otitis media group maintained stable word recognition scores without a decline, despite having experienced hearing loss for more than 20 years. The research team analyzed that the remaining bone-conduction hearing in patients with chronic otitis media may have continuously stimulated the auditory system, helping preserve auditory pathways and nerve function.
However, preoperative magnetic resonance imaging (MRI) showed that 9.1% of patients with chronic otitis media also had labyrinthitis. Patients with labyrinthitis had significantly lower postoperative word recognition scores than the other patients. This indicates that the presence of labyrinthitis is an important indicator for predicting the prognosis after CI surgery.
Professor Park Hong-joo said, "This study suggests that even patients who have experienced hearing loss for a long time due to chronic otitis media and can no longer benefit from hearing aids should not lose hope, as they may successfully regain hearing through a cochlear implant." He added, "For successful CI surgery, it is important to check for labyrinthitis through detailed imaging examinations, including preoperative MRI, and establish an optimal treatment plan."
He continued, "There are various treatment options for hearing loss, and the earlier it is treated, the more effectively it can be overcome. With recent advances in science and technology, auditory rehabilitation is possible through various methods for most patients, regardless of the severity of their hearing loss. Treating hearing loss improves quality of life by facilitating social activities, reducing depression, and improving cognitive function."
The findings were published in the latest issue of the international otolaryngology journal Ear, Nose & Throat Journal.

 


[email protected] Medical Correspondent Park Hong-joo Reporter