# Impact of Surgical Treatment on the Quality of Life in Patients With Chronic Otitis Media With Cholesteatoma: A Prospective Study

## TL;DR

This study shows that surgery improves quality of life for patients with chronic otitis media with cholesteatoma, especially in symptoms and emotional well-being.

## Contribution

The study evaluates the effectiveness of surgical treatment on quality of life using a validated Mexican-specific questionnaire.

## Key findings

- Surgical treatment significantly improved quality of life scores in patients with COMC.
- The COMQ-12-Mx questionnaire effectively detected postoperative changes in clinical outcomes.
- Canal wall up techniques showed significant improvement in hearing function.

## Abstract

Introduction

Chronic otitis media with cholesteatoma (COMC) is a progressive and potentially destructive middle ear disease, with surgery as the treatment of choice. Its auditory, emotional, and social consequences significantly affect patients’ quality of life. The Chronic Otitis Media Questionnaire-12, Mexican version (COMQ-12-Mx), allows a validated assessment of this impact in the Mexican population.

Objective

The main objective of this study is to evaluate the effect of surgical treatment on quality of life and auditory function in patients with COMC, using the COMQ-12-Mx.

Material and methods

A prospective cohort study was conducted at the University Center of Otolaryngology and Head and Neck Surgery, “Dr. José Eleuterio González” University Hospital, Monterrey, Mexico, from May to October 2025. Twenty-five adults with clinically and radiologically confirmed COMC were included. The COMQ-12-Mx and audiometric tests were applied before and three months after surgery.

Results

Twenty-five affected ears were analyzed (median age 47 years; 56% female). The most frequent comorbidities were type 2 diabetes (32%), bilateral chronic otitis media (28%), and hypertension (16%). Main symptoms included tinnitus (68%), otalgia (64%), and otorrhea (64%). The attic-antral region was most commonly involved (68%). Simple mastoidectomy (76%) and type III tympanoplasty (78.6%) were the predominant techniques. Postoperative complications occurred in 24%, mainly graft perforation (16%). The pure-tone average (PTA) showed a trend toward improvement (48 dB preoperative vs 42 dB postoperative; p = 0.059). Total COMQ-12-Mx scores significantly decreased (29 vs 21; p < 0.001), with improvement across all subdomains and a large effect size (r = 0.87). Both canal wall up (CWU) and endoscopic techniques improved global scores, while only CWU showed significant PTA improvement (p = 0.041).

Conclusions

Surgery for COMC was associated with within-group improvement in quality of life, particularly in symptoms and emotional impact. The COMQ-12-Mx adequately detected postoperative changes and served as a reliable tool to assess clinical and functional outcomes after surgical treatment.