scholarly journals Frequency Dependence Hearing Loss Evaluation in Perforated Tympanic Membrane

2017 ◽  
Vol 21 (04) ◽  
pp. 336-342 ◽  
Author(s):  
Mohammed Dawood
Keyword(s):  
Hearing Loss ◽  
Frequency Dependence ◽  
Tympanic Membrane ◽  
Cross Sectional Study ◽  
Tympanic Membrane Perforation ◽  
Hearing Level ◽  
Cross Sectional ◽  
Maximum Loss ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation

Introduction Tympanic membrane perforation is a relatively common problem that predisposes patients to varying degrees of conductive hearing loss. Objective The objective of this study is to evaluate and analyze the frequency dependence hearing loss in tympanic membrane perforation based on the size and the site of perforation. Methods For the study, I selected 71 patients' (89) ears for the cross-sectional study with tympanic membrane perforations; I examined the size and the site of perforations under the microscope and classified them into small, moderate, large, and subtotal perforations, and into anterior central, posterior central, malleolor central, and big central perforations. I measured mean level of speech frequencies hearing loss, and its relation with the site and the size of the perforation analyzed. Results The mean hearing loss at different sizes of the perforation at all speech frequencies was 37.4 dB, with ABG of 26.6 dB, and its maximum loss was detected in subtotal perforation of 42.3 dB, with ABG of 33.7 dB, at 500 Hz frequency, while in relation to the sites, it was 38.2 dB, with ABG of 26.8 dB, and its maximum loss was detected in big central site perforation of 42.1 dB, with ABG of 33.6 dB, at 500 Hz frequency. Conclusions The hearing loss was proportionally related with the sizes of the perforations, and the posterior site had greater impact on the hearing than anterior site perforations. This was also applied to the frequency dependence hearing level, as was detected to be worse at lower frequencies as 500 Hz, than those of 1000–2000 Hz.

scholarly journals Audiometric assessment of adolescents and adults with tympanic membrane perforation in Benin City

2018 ◽  
Vol 4 (4) ◽  
pp. 901 ◽  
Author(s):  
Johnson Ediale ◽  
Paul R. O. C. Adobamen ◽  
Titus S. Ibekwe
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Pure Tone Audiometry ◽  
Cross Sectional Study ◽  
Tympanic Membrane Perforation ◽  
Adult Patients ◽  
Hearing Level ◽  
Cross Sectional ◽  
Benin City ◽  
Membrane Perforation

<p class="abstract"><strong>Background:</strong> The degree of hearing loss is directly proportional to the size of tympanic membrane (TM) perforation. However, there is dearth of information on correlation between severity of hearing loss and location of perforation on the tympanic membrane. The objective of the study was to determine the hearing level of adolescent and adult patients with tympanic membrane perforation.</p><p class="abstract"><strong>Methods:</strong> A cross sectional study at the ENT Clinic, University of Benin Teaching Hospital (U.B.T.H), Benin City. Consecutive patients with TM perforations were examined with ‘‘Firefly video-otoscope’’, and subsequently had pure tone audiometry. The contralateral intact TMs in individuals with unilateral TM perforation and the ears of students and staff of Institute of Health Technology UBTH were used as control. Data was analyzed using statistical package for social sciences (SPSS) version 20 and Image J software. P≤0.05 was considered statistically significant.  </p><p class="abstract"><strong>Results:</strong> Two hundred ears from 148 patients with TM perforation in either or both ears were studied. Conductive hearing loss (CHL) had the highest prevalence; 64.3% and 55.9% in the right and left ears respectively. Slight CHL; 67.5% was more common. However, the severity of hearing loss increased with the size and also varied with the location of TM perforation.</p><p><strong>Conclusions:</strong> The hearing level among adolescent and adult patients with TM perforation showed a significant association with the size and the location of the perforation on the TM.</p>

scholarly journals Hearing loss in tympanic membrane perforations: an analytic study

2018 ◽  
Vol 4 (5) ◽  
pp. 1233 ◽  
Author(s):  
Kartik Herkal ◽  
Karthikeyan Ramasamy ◽  
Sunil Kumar Saxena ◽  
Sivaraman Ganesan ◽  
Arun Alexander
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Pure Tone Audiometry ◽  
Cross Sectional Study ◽  
Tympanic Membrane Perforation ◽  
Sectional Study ◽  
Cross Sectional ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation ◽  
R Value

<p class="abstract"><strong>Background:</strong> Tympanic membrane perforations are common cause of hearing loss. There are very few systematic studies that have evaluated the size and location of a perforation to the degree of hearing loss, this study correlates the size and location of tympanic membrane perforation to the pattern of hearing loss.</p><p class="abstract"><strong>Methods:</strong> The study design was based on cross sectional study. Ninety-six ears of dry tympanic membrane perforation of CSOM mucosal type were selected. Photographs of the tympanic membrane perforations were taken and size measured using the “Image J” software. The area of perforation was compared to hearing loss measured by pure tone audiometry.  </p><p class="abstract"><strong>Results:</strong> Ninety-six patients, aged 15-60 years with perforated eardrums were studied. Size of tympanic membrane perforation showed moderate level of correlation with hearing loss (Pearson r value=0.463). The various locations of perforations were: posterior (23 ears with Mean hearing loss 28.6±7.7 dB), anterior (31 ears with Mean hearing loss 26.5±7.8dB), subtotal (42 ears with Mean hearing loss 34.2±8.2 dB).</p><p class="abstract"><strong>Conclusions:</strong> The hearing loss is frequency dependent, with maximum hearing loss at lower frequencies. Irrespective of size of perforation the hearing loss was the least for frequency of 2000Hz. Magnitude of hearing loss increases with increase in size of tympanic membrane perforation. Perforation posterior to handle of malleus resulted in more hearing loss than perforations involving anterior to the handle of malleus.</p>

Determinants of hearing loss severity in tympanic membrane perforations in a sub-Saharan African setting

2018 ◽  
Vol 132 (11) ◽  
pp. 1013-1017
Author(s):  
E Choffor-Nchinda ◽  
F Djomou ◽  
R-C Meva'a Biouele ◽  
D Mindja ◽  
A Bola ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Pure Tone Audiometry ◽  
Tympanic Membrane Perforation ◽  
Sub Saharan Africa ◽  
Cross Sectional ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation ◽  
Sub Saharan ◽  
Loss Severity

AbstractBackgroundFactors specific to sub-Saharan Africa could have an impact on tympanic membrane perforation characteristics. Obtaining precise information on these characteristics and determinants of hearing loss severity would enable better management.ObjectiveTo determine the relationship between characteristics of tympanic membrane perforation and subsequent hearing impairment.MethodsA cross-sectional study of consenting patients presenting with tympanic membrane perforation was conducted. They were examined using otoendoscopy with a digital camera to obtain precise measurements, followed by pure tone audiometry.ResultsEighty-six cases of tympanic membrane perforation were included. Mean tympanic membrane perforation proportion was 34.1 ± 18.4 per cent. Medium-sized tympanic membrane perforations were predominant (47.7 per cent). Median tympanic membrane perforation duration was 20 years. Tympanic membrane perforation size was found to be a predictor of hearing loss severity (odds ratio = 2.5, 95 per cent confidence interval = 1.02–6.13,p= 0.04).ConclusionTympanic membrane perforation size was a predictor of hearing loss severity in our setting. Site, duration and aetiology seem to have no impact on hearing loss severity.

scholarly journals Correlation of Site and Size of Tympanic Membrane Perforation and Middle Ear Air Space Volume with Magnitude of Hearing Loss

2019 ◽  
Vol 02 (01) ◽  
pp. 10-15
Author(s):  
Ramandeep Singh Virk ◽  
Krishan Kudawla ◽  
Sandeep Bansal ◽  
Ramya Rathod ◽  
Samarendra Behera
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Middle Ear ◽  
Tympanic Membrane Perforation ◽  
Tympanic Membrane Perforations ◽  
Air Space ◽  
Membrane Perforation ◽  
Volume Group ◽  
Space Volume ◽  
Lower Frequencies

Abstract Introduction The effects of tympanic membrane perforations on middle ear sound transmission are not well characterized, largely because ears with perforations typically have additional pathological changes. It has been established that the larger the perforation, the greater is the hearing loss (HL). Aim This study aimed to correlate the location and size of tympanic membrane perforation and middle ear air space volume with the magnitude of HL in patients with tubotympanic or inactive mucosal type of chronic otitis media (COM). Materials and Methods A prospective clinical study of patients with tympanic membrane perforations due to COM and without any other ear disease and who attended the Otolaryngology services at our institute between July 2010 and December 2011 was conducted. A total of 300 ears were evaluated by performing otoendoscopy, followed by photo documentation and audiological investigations (pure-tone audiometry and tympanometry). Tympanic membrane perforations were categorized based on their size and location, and the mean air-bone (AB) gap between the various types of perforations was compared and statistically analyzed with significance level of p < 0.05. Results Out of 300 ears, maximum number of ears (n = 124, 41.3%) had large-sized perforations (> 30 mm2) that had a maximum mean AB gap of 26.43 dB, and minimum number of ears (n = 60, 20%) had small-sized perforations (0–9 mm2) that had minimum mean AB gap of 9.12 dB. The remaining were medium-sized perforations that had mean AB gap of 16.13 dB. Depending on the location, maximum were central perforations (n = 198, 66%) and minimum were anterosuperior (AS) perforations (n = 9, 3%). Based on the middle ear volume on tympanometry, maximum ears were of low-volume group (n = 246, 92%) that had larger mean AB gap of 19.96 dB HL when compared with the high-volume group (n = 24, 8%) with 11.80 dB HL. AB gap was maximum at lower frequencies and decreased with increase in frequencies except at 4,000 Hz, that is, 56.9 dB HL at 250 Hz, 42.6 at 500 Hz, 41.5 at 1,000 Hz, 32.4 at 2,000 Hz, and 49.5 at 4,000 Hz. Conclusion HL increases as the area of tympanic membrane perforation increases. There is an inverse relationship between HL and middle ear air space volume. Comparing the small-sized perforations at different sites with the middle ear volume being low, it was found that posterosuperior (PS) perforations had 4 to 7 dB greater HL than AS and anteroinferior (AI). However, the relationship was statistically insignificant. The phase cancellation effect of round window causing greater HL in posteroinferior (PI) perforations does not exist in small- and medium-sized perforations. HL is greater at lower frequencies and less at higher frequencies.

scholarly journals Tympanic membrane perforation: correlation of hearing loss with its site and size

2018 ◽  
Vol 4 (2) ◽  
pp. 397 ◽  
Author(s):  
Arvinder Singh Sood ◽  
Pooja Pal ◽  
Amit Kumar
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Linear Correlation ◽  
Tympanic Membrane Perforation ◽  
P Value ◽  
Cross Sectional ◽  
Group Iii ◽  
Group I ◽  
Membrane Perforation ◽  
Group Ii

<p class="abstract"><strong>Background:</strong> The objectives of the study were <span lang="EN-IN">correlation of hearing loss with size and site of tympanic membrane perforation. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A cross-sectional prospective study of 100 patients of both sex and age between 11-60 years with perforated tympanic membrane was conducted in the department of Otorhinolaryngology (ENT). Size and site of TM perforation was assessed using otoscope and otomicroscope. Size of perforation was measured with 1 mm thin wire loop and vernier caliper. Patients were divided into three groups according to size; Group I (0-9 mm), Group II (9-30 mm), Group III (&gt;30 mm). The tympanic membrane was divided into five segments anterosuperior, posterosuperior, anteroinferior, posteroinferior and central for the localization of the site of perforation. Data thus collected was statistically analysed.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Patients with Group I perforation had an average hearing loss of 31.42±7.15 decibel. Group II had an average hearing loss of 39.42±8.97 decibel. Group III had an average hearing loss of 48.91±7.38 decibel. Maximum hearing loss was noted in patients with central perforation with an average hearing loss of 39.34±9.47 decibel. Average hearing loss was found higher in posterior perforations than anterior quadrant perforations. This difference was however not statistically significant with ‘p’ value of ‘0.689’. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Linear correlation was found between size of tympanic membrane perforation and degree of hearing loss. No linear correlation between site of tympanic membrane perforation and hearing loss was found. We found no correlation between duration of disease and size of tympanic membrane perforation with degree of hearing loss.</span></p>

scholarly journals Observation of hearing loss in patients with chronic suppurative otitis media tubotympanic type

1970 ◽  
Vol 7 (4) ◽  
pp. 397-401 ◽  
Author(s):  
M Maharjan ◽  
P Kafle ◽  
M Bista ◽  
S Shrestha ◽  
KC Toran
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Chronic Suppurative Otitis Media ◽  
Common Finding ◽  
Hearing Level ◽  
Suppurative Otitis Media ◽  
Low Frequencies ◽  
Membrane Perforation

Background: It is acknowledged that size and site of tympanic membrane perforation is proportional to degree of hearing loss but there are many studies which suggests otherwise. Persistent ear discharge is also supposed to deteriorate hearing level with passage of time. This study is carried out to find out the relation between size and site of tympanic membrane perforation and duration of ear discharge on hearing loss. Objectives: The objective of this study is to study the effect of size and site of tympanic membrane perforation and duration of ear discharge on hearing loss. Materials and methods: This is a cross-sectional prospective study conducted at Kathmandu Medical College, department of ear nose and throat from January till July 2009. One hundred patients aged between 8 to 60 years with pars-tensa perforations were included in the study. Detail clinical examination and history was carried out followed by hearing evaluation by audiometry was done in all cases. All the data is collected, statistical analysis is done using SPSS program and documented for study. Results: One hundred patients with 119 perforated tympanic membrane, age ranged between 8 to 60 years, 44 males and 56 females were studied. Bilateral tympanic membrane perforation were seen in 19 patients, right sided perforation in 39 and left sided in 42 patients respectively. Large central perforation involving all four quadrants was the most common otologic findings seen in 72 ears (60.50%) whereas perforation in posterosuperior quadrant was the least common finding seen in 3 patients (2.52%). Significant relation is observed between site of perforation and degree of hearing loss; posterior placed perforations seem to have larger hearing loss. Ninety-five perforations (79.83%) showed more loss in low frequencies with larger air bone gap at low frequencies. The longer the duration of ear discharge, the more the hearing loss. Conclusion: The larger the perforation, the greater the decibel loss in sound perception. The location of perforation on the tympanic membrane and the duration of ear discharge have significant effect on the magnitude of hearing loss. Key words: chronic suppurative otitis media; tympanic membrane perforation; hearing loss DOI: 10.3126/kumj.v7i4.2761 Kathmandu University Medical Journal (2009) Vol.7, No.4 Issue 28, 397-401

scholarly journals A STUDY ON CORRELATION OF SIZE AND SITE OF TYMPANIC MEMBRANE PERFORATION WITH DEGREE OF CONDUCTIVE HEARING LOSS IN CHRONIC OTITIS MEDIA

2021 ◽  
Vol VOLUME 9 (ISSUE 1) ◽  
pp. 19-23
Author(s):  
M Lavanya
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Conductive Hearing Loss ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Tympanic Membrane Perforations ◽  
Posterior Quadrant ◽  
Membrane Perforation ◽  
Duration Of Disease ◽  
Conductive Hearing

Background: Tympanic membrane perforations are common cause of hearing loss. This study was designed to analyze the relation between tympanic membrane perforation and conductive hearing loss. Materials and Methods: In this prospective study, patients with dry tympanic membrane perforations of safe type were included. The patients were divided into groups in according to size, site and duration of perforation. Based on the inclusion and exclusion criteria a total of 100 patients were included in this study. All the patients clinical data was analyzed statistically using paired t-test. Results:Hearing loss increased as the size of perforation increased. Posterior quadrant perforations were associated with more hearing loss as compared to anterior quadrant perforations. Also duration of disease was in linear relation with mean hearingloss. Conclusions: The degree of conductive hearing loss as a result of tympanic membrane perforation would be expected with the size, site and duration of perforation. Keywords: Tympanic membrane, Conductive hearing loss, Perforation, hearing loss, posterior quadrant, ear.

scholarly journals Comparative assessment of hearing in various tympanic membrane perforations in patients at Bhuj, Kutch, Gujarat, India: a cross sectional study

2017 ◽  
Vol 3 (2) ◽  
pp. 273 ◽  
Author(s):  
Hardik Darad ◽  
Mohit Sinha
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Medical Science ◽  
Neck Surgery ◽  
Cross Sectional Study ◽  
Tympanic Membrane Perforation ◽  
Sectional Study ◽  
Cross Sectional ◽  
Suppurative Otitis Media ◽  
Posterior Quadrant

<p class="abstract"><strong>Background:</strong> The objective of the present study was to correlate the size and site of perforation with hearing loss in chronic suppurative otitis media (CSOM).</p><p class="abstract"><strong>Methods:</strong> The cross sectional study was conducted among a<strong> </strong>purposive sample of first 100 consecutive patients of unilateral<strong> </strong>inactive mucosal CSOM, who underwent myringoplasty at Department of otorhinolaryngology and Head and Neck Surgery Gujarat Adani Institute of Medical Science, Bhuj, Kutch, Gujarat. One hundred consecutive patients fulfilling the inclusion criteria were included in the study. In all the patients, a detailed history and a thorough ENT examination was followed by hearing assessment and measurement of the size of the perforation.  </p><p class="abstract"><strong>Results:</strong> Infection was the most common etiology of tympanic membrane perforation in 92 (92%) cases and trauma in 08 (08%) with otorrhea as the most common presenting complaint. Half of the cases were in the age group of 20–30 years. Seventy-nine percentage cases had mild hearing loss whereas 19% had moderate hearing loss. Anterior quadrant perforations on an average had 31.4 dB hearing loss, whereas there was 43.9 dB average hearing loss in posterior quadrant perforations.</p><p class="abstract"><strong>Conclusions:</strong> It was observed that there is direct relationship between size and site of perforation and loss of hearing. There was less hearing loss in small sized perforations. Posterior quadrant perforations and malleolar perforations (MLs) had a greater hearing loss than anterior, multiple quadrant, or non‑MLs.</p>

scholarly journals Hearing assessment in patients with tympanosclerosis with intact tympanic membrane

2020 ◽  
Vol 6 (2) ◽  
pp. 291
Author(s):  
Ramya Bandadka ◽  
Afshan Tarannum ◽  
Narasaiah Dhanapala
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Incidental Finding ◽  
Pure Tone Audiometry ◽  
Cross Sectional Study ◽  
Hearing Level ◽  
Cross Sectional ◽  
Medical College ◽  
Hearing Assessment ◽  
Intact Tympanic Membrane

<p class="abstract"><strong>Background:</strong> Tympanosclerosis is an irreversible, though not immutable, end result of any unresolved specific or nonspecific inflammatory disease of middle ear characterized by anatomical distortion resulting in functional impairment. The objective of the study was to assess hearing in patients with tympanosclerosis with intact tympanic membrane (TM) and to correlate degree of hearing loss with respect to site of tympanosclerotic patch on TM.</p><p class="abstract"><strong>Methods:</strong> This cross-sectional study was conducted at Bangalore Medical College and Research Institute, Bangalore during study period from November 2016 to May 2018. Thirty patients enrolled for study were subjected to otoendoscopy, pure tone audiometry and tympanometry. Site of tympanosclerotic patch on tympanic membrane and hearing loss were assessed and correlated statistically.  </p><p class="abstract"><strong>Results:</strong> Thirty patients (13-males, 17-females), aged 6–73 years (average-39.5 years) who fulfilled inclusion criteria were included. 7 (23.3%) patients had bilaterally affected ears amounting to 37 tympanosclerotic ears. left ear was commonly affected 14 (46.6%). In most patients, tympanosclerosis of tympanic membrane was an incidental finding with patients being otologically asymptomatic. The locations of tympanosclerotic patch on TM were 9 (24.4%) postero-superior, 7 (18.9%) postero-superior and postero-inferior, 7 (18.9%) antero-inferior, 5 (13.5%) postero-inferior, 3 (8.1%) antero-superior, 3 (8.1%) antero-superior and antero-inferior, 2 (5.4%) antero-inferior and postero-inferior and 1 (2.7%) entire pars tensa. Hearing level ranged from 10-46.6 dBHL (normal to moderate) with majority (91.89%) of patients had hearing within 25 dBHL. 43.3% had conductive hearing loss, 2.7% had sensorineural hearing loss and rest had normal hearing. Correlation of site of tympanosclerotic patch on TM with degree of hearing loss was not statistically significant (p=0.058).</p><p class="abstract"><strong>Conclusions:</strong> Variations in the site of tympanosclerotic patch on TM do not affect degree of hearing loss.</p>

scholarly journals Correlation of tympanic membrane perforations with hearing loss

2019 ◽  
Vol 5 (5) ◽  
pp. 1213
Author(s):  
Mirza Aneesa ◽  
Samreen Siraj ◽  
Arshid Ali
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Conductive Hearing Loss ◽  
Tympanic Membrane Perforation ◽  
Tympanic Membrane Perforations ◽  
Posterior Quadrant ◽  
Membrane Perforation ◽  
Duration Of Disease ◽  
Conductive Hearing ◽  
Paired T Test

<p class="abstract"><strong>Background:</strong> Tympanic membrane perforations are common cause of hearing loss. This study was designed to analyze the relation between tympanic membrane perforation and hearing loss.</p><p class="abstract"><strong>Methods:</strong> In this prospective study, patients with dry tympanic membrane perforations of safe type were included. The patients were divided into groups in according to size, site and duration of perforation.  </p><p class="abstract"><strong>Results:</strong> 49 patients with 70 dry tympanic membrane perforations were studied. Data was analyzed statistically using paired t-test. Hearing loss increased as the size of perforation increased. Posterior quadrant perforations were associated with more hearing loss as compared to anterior quadrant perforations. Also duration of disease was in linear relation with mean hearing loss.</p><strong>Conclusions:</strong>The degree of conductive hearing loss as a result of tympanic membrane perforation would be expected with the size, site and duration of perforation.<p> </p>

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