Preoperative Serum Total IgE Category and 6-Month Tympanometric Status After Type I Tympanoplasty for Chronic Otitis Media

Objective: To evaluate whether preoperative serum total IgE, analyzed categorically and continuously, was associated with 6-month postoperative tympanometric status after type I tympanoplasty for chronic otitis media. Tympanic membrane closure and audiometric outcomes were also examined. Methods: This retrospective study included 171 operated ears from 171 unique patients with chronic otitis media who underwent type I tympanoplasty. The categorical analysis used the institutional assay upper reference limit of 60 IU/mL; a separate analysis treated IgE as a log2-transformed continuous variable. Tympanic membrane closure, tympanometry, and audiometry were assessed at 6 months. Abnormal tympanometric status was defined as a measurable peak pressure < −50 daPa or a type B tympanogram. Multivariable logistic regression evaluated factors associated with abnormal tympanometric status. Results: Of 171 patients, 101 had serum total IgE ≤ 60 IU/mL and 70 had IgE > 60 IU/mL. Abnormal 6-month tympanometric status occurred in 22/89 (24.7%) and 29/61 (47.5%) ears, respectively (p = 0.005). Tympanic membrane closure was 96/98 (98.0%) versus 61/68 (89.7%) (p = 0.033). A 6-month ABG ≤ 20 dB occurred in 87/94 (92.6%) versus 54/64 (84.4%) (p = 0.121). In complete-case multivariable analysis, IgE > 60 IU/mL (OR, 3.46; 95% CI, 1.56–7.70; p = 0.002) and poor mastoid pneumatization (OR, 4.68; 95% CI, 2.15–10.21; p < 0.001) were associated with abnormal tympanometric status. In the separate continuous analysis, each doubling of IgE was associated with higher adjusted odds of abnormal tympanometric status (OR, 1.25; 95% CI, 1.03–1.52; p = 0.023). Conclusions: Preoperative serum total IgE was associated with abnormal 6-month tympanometric status in both categorical and continuous analyses. The 60 IU/mL cutoff was an assay-specific reference limit rather than a validated postoperative risk threshold. The findings do not establish predictive or prognostic utility, clinically defined allergy, or an allergy-mediated causal mechanism.