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

Background: 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.Methods: 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. Results: 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.Conclusions: 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.

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Frequency Dependence Hearing Loss Evaluation in Perforated Tympanic Membrane

International Archives of Otorhinolaryngology ◽

10.1055/s-0037-1598597 ◽

2017 ◽

Vol 21 (04) ◽

pp. 336-342 ◽

Cited By ~ 3

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.

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Hearing loss in tympanic membrane perforations: an analytic study

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20183693 ◽

2018 ◽

Vol 4 (5) ◽

pp. 1233 ◽

Cited By ~ 2

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

Background: 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.Methods: 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. Results: 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).Conclusions: 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.

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

The Journal of Laryngology & Otology ◽

10.1017/s0022215118001962 ◽

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.

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Hearing assessment in patients with tympanosclerosis with intact tympanic membrane

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20200140 ◽

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

Background: 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.Methods: 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. Results: 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).Conclusions: Variations in the site of tympanosclerotic patch on TM do not affect degree of hearing loss.

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A Correlative Study Between Size of Tympanic Membrane Perforation, Pure Tone Audiometry and Intraoperative Findings in Tympanoplasty

Bengal Journal of Otolaryngology and Head Neck Surgery ◽

10.47210/bjohns.2018.v26i1.155 ◽

2018 ◽

Vol 26 (1) ◽

pp. 43-47

Author(s):

Santosh U P ◽

Sridurga J ◽

Aravind D R

Keyword(s):

Hearing Loss ◽

Tympanic Membrane ◽

Otitis Media ◽

Middle Ear ◽

Pure Tone ◽

Chronic Otitis Media ◽

Pure Tone Audiometry ◽

Tympanic Membrane Perforation ◽

Membrane Perforation ◽

Operative Findings

Introduction Chronic otitis media (COM) is a most common and prevalent disease of the middle ear. COM has been defined as a longstanding inflammatory condition of middle ear and mastoid, associated with perforation of the tympanic membrane. Tympanoplasties are common surgeries performed for chronic otitis media in inactive mucosal type. Any otological surgery may involve a menace/ hazard of hearing loss post operatively. In this study, an attempt was made to correlate, size of tympanic membrane perforation, pure tone audiometry and intra-operative findings in tympanoplasties, results were analysed and conclusion drawn. Materials and Methods Forty patients attending ENT OPD with chronic otitis media (COM), inactive mucosal type, with conductive hearing loss undergoing tympanoplasties who were willing to participate in the study were selected. Ear was examined pre-operatively to assess the size of perforation and then, pure tone audiometry (PTA) was done to assess the type of hearing loss and its severity. During tympanoplasty, middle ear was inspected for ossicular status and any other pathology was noted. Later, the size of tympanic membrane perforation, pure tone audiometry and intra operative findings were correlated with each other and analysed. Result In small and medium sized perforation, PTA and intraoperative findings correlated with each other. Whereas, in large and subtotal perforation, there was no correlation. Conclusion In small and medium sized perforation, middle ear inspection may not be necessary. Whereas, in large and subtotal perforation it is necessary.

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

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20180016 ◽

2018 ◽

Vol 4 (2) ◽

pp. 397 ◽

Cited By ~ 1

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

Background: The objectives of the study were correlation of hearing loss with size and site of tympanic membrane perforation. Methods: 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 (>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. Results: 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’. Conclusions: 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.

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

Kathmandu University Medical Journal ◽

10.3126/kumj.v7i4.2761 ◽

1970 ◽

Vol 7 (4) ◽

pp. 397-401 ◽

Cited By ~ 8

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

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A study of status of contralateral ear in unilateral chronic otitis media in 500 patients

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20195579 ◽

2019 ◽

Vol 6 (1) ◽

pp. 34

Author(s):

Prabaakharan Jambunathan ◽

Arvinder S. Maan ◽

Karan Sharma

Keyword(s):

Hearing Loss ◽

Tympanic Membrane ◽

Otitis Media ◽

Chronic Otitis Media ◽

Pure Tone Audiometry ◽

Cross Sectional Study ◽

High Resolution Computed Tomography ◽

Cross Sectional ◽

Mixed Hearing Loss ◽

Contralateral Ear

Background: The aim of this study was to examine the contralateral ear clinically, audiologically and radiologically and compare the findings with squamous and mucosal type of chronic otitis media (COM).Methods: A cross sectional study conducted in patients attending ENT Department, Government Medical College, Amritsar between December 2016 to November 2018. The study was conducted in 500 patients of either sex aged between 8 to 60 years with unilateral COM without perforation or history of ear discharge in the contralateral ear. Otoscopy, pure tone audiometry and X-ray mastoid or high-resolution computed tomography temporal bone were done on the patients. The results were recorded and analysed with SPSS software. Results: 82% patients were found to have some abnormalities in the contralateral ear. On otoscopy abnormalities in contralateral ear includes retraction of tympanic membrane, thinning and tympanosclerotic patch, most common abnormality being retraction of tympanic membrane. Radiological analysis of contralateral mastoids showed 39% diploic and 22.8% sclerotic mastoids. Hearing status in the contralateral ear showed 45.6% patient with normal hearing, 48.6% with conductive hearing loss and 5.8% with mixed hearing loss. 40.4% contralateral ears had mild, 12% had moderate and 2% had severe hearing loss.Conclusions: Contralateral ear pathologies were more in those who had squamosal type of COM than who had mucosal type in the diseased ear. The contralateral ear shows unmistakable predilection towards developing COM in the future.

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

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20170932 ◽

2017 ◽

Vol 3 (2) ◽

pp. 273 ◽

Cited By ~ 2

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

Background: The objective of the present study was to correlate the size and site of perforation with hearing loss in chronic suppurative otitis media (CSOM).Methods: The cross sectional study was conducted among a purposive sample of first 100 consecutive patients of unilateral 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. Results: 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.Conclusions: 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.

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Traumatic perforation: determinants of conductive hearing loss

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20172583 ◽

2017 ◽

Vol 3 (3) ◽

pp. 592

Author(s):

Ravi K. S. ◽

Ravishankar S. N.

Keyword(s):

Hearing Loss ◽

Tympanic Membrane ◽

Conductive Hearing Loss ◽

Previous History ◽

Pure Tone Audiometry ◽

Tympanic Membrane Perforation ◽

Tertiary Center ◽

Membrane Perforation ◽

History Of ◽

Conductive Hearing

Background: Traumatic perforations of the tympanic membrane are very common in day to day life and it may be due to direct or indirect source. The aim of this study is to evaluate the various factors which determine the degree of hearing loss in patients with traumatic perforation of tympanic membrane. Methods: A retrospective review was performed in 50 patients seen at the ENT department in our rural tertiary center over a period of two years between January 2015 to December 2016. The patients with history of ear trauma from various causes and with absolutely no previous history of any ear disease were included in our study. The data retrieved included parameters such as age, sex, side, cause of injury and presenting complaints such as hearing loss, earache, tinnitus, and vertigo. A detailed clinical and otoscopic examination was done to determine the size and location of the perforation. Hearing was assessed using pure tone audiometry (PTA) to determine the degree of hearing loss and to correlate with frequency, size and location of perforation. Results: A total of 50 patients with traumatic perforations of the tympanic membrane were enrolled for the study, comprising of 32 males and 18 females patients. Age of the patients ranged from12 to 65 years of age. The results showed that the most common mode of trauma was RTA (46%). Audiometry shows that the larger the tympanic membrane perforation, the larger the air–bone gap. Hearing loss was highest at the lowest frequencies and generally decreased as the frequency increased. The results also showed that there was no difference in air bone gap with relation to location of perforation (anterior vs. posterior). Conclusions: The conductive hearing loss resulting from a tympanic membrane perforation is frequency dependent, with the largest losses occurring at the lowest sound frequencies, hearing loss increases as size of the perforation increases and no relation with location of perforation.

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