Sub-clinical middle ear malfunctions in elderly patients; prevalence, pattern and predictors.

Olusola Ayodele Sogebi1, Taiwo Olugbemiga Adedeji2, Olatundun Ogunbanwo3, Emmanuel Abayomi Oyewole1
1. Department of Surgery, OACHS, Olabisi Onabanjo University, Sagamu, Nigeria.
2. Department of Otorhinolaryngology, Head and Neck Surgery LAUTECH Teaching Hospital, Osogbo, Nigeria.
3. Department of ENT, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.

Abstract:
Background: Little is known about functioning of the middle ear with advancing age.

Objectives: To estimate the prevalence and describe tympanometric patterns of sub-clinical middle ear malfunctions,( S-MEM)
in elderly patients. It also assessed clinical factors that could predict S-MEM.

Methods: Cross-sectional, analytical study of patients aged ≥ 60 years in a tertiary hospital in Nigeria between 2011-2014. Pure
tone audiometry (PTA), tympanometry and acoustic reflexes were recorded. S-MEM was based on audiometric and tympanometric evident abnormalities. Descriptive, univariate and multivariate analyses performed to detect independent clinical predictors of S-MEM at p-value of <0.05.

Results: 121 patients , M: F of 1.1:1. Mean age was 70.1 ± 6.2 years, 77.7% were married. Prevalence of S-MEM was 21.5%. Abnormal tympanometric tracings were type AS>C>B>AD. The parameters that were statistically-signifcant on univariate analyses were subjected to logistic regression analysis which confrmed previous head injury, diabetes, osteoarthritis of knee joint, and absent acoustic reflex as clinical predictors for S-MEM.

Conclusion: 21.5% of elderly Africans had subclinical abnormalities in their middle ear functioning, mostly with type AS tympanogram. Independent clinical predictors of S-MEM included previous head injury, diabetes, history of osteoarthritis of knee joints, and absent acoustic reflex.

Keywords: Middle ear malfunctions, elderly patients.