(1032) Hearing Loss After Otitis Media in the Immunocompromised Pediatric Population

Introduction: Immunocompromised (IC) children are known to be at increased risk of developing otitis media (OM); however, the long-term consequences of OM in this population remain unclear. This study investigates the long-term otologic outcomes of OM in IC patients using the TriNetX Research Network, a multi-institutional database.

Methods: Patients ages 0-18 were divided into cohorts based on the presence of IC conditions including: combined immunodeficiencies (CID), primarily humoral immunodeficiencies (HID), cystic fibrosis (CF), human immunodeficiency virus infection (HIV), leukemia/lymphoma, and disorders of polymorphonuclear neutrophils (CGD). Primary outcomes included conductive hearing loss (CHL), sensorineural hearing loss (SNHL), hearing aid use (HA), cochlear implantation (CI), meningitis, and mastoiditis. Surgical treatment with mastoidectomy or tympanoplasty/myringotomy after OM was also assessed. Odds ratio (OR) and 95% confidence interval calculations were made in reference to pediatric patients without any of the IC conditions (controls).

Results: When compared to controls (n = 2,504,483), as a group, IC patients (n = 10,439) had significantly increased odds of all measured outcomes (p < 0.0001). Patients with leukemia/lymphoma were at highest risk of meningitis following OM compared to the control cohort [OR = 17.9 (13-24.5), p < 0.0001]. CHL occurred in 8.8% (CF) to 17.3% (CID) of patients; SNHL occurred in 2.4% (CF) to 8.7% (CGD) of patients. HA and CI use in the IC group were 6.5% [OR = 5.35, 95% CI: (4.95-5.79); p < 0.0001] and 0.89% [OR = 12.2, (CI: 9.82-15.1); p < 0.0001], respectively. IC patients were more likely to undergo mastoidectomy [OR = 6.09, (4.41-8.41); p < 0.0001] and tympanoplasty/myringotomy [OR = 4.12, (3.92-4.34); p < 0.0001] compared to controls.

Conclusions: This is the largest study examining the relationship between IC status and outcomes after OM. IC patients are significantly more likely than non-IC controls to undergo surgical procedures and require hearing aids or cochlear implantation to treat hearing loss.