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>

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.

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

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. 

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 Role of Hum Test in Diagnosis of Hearing Loss

2020 ◽  
Vol 4 (3) ◽  
pp. 782-785
Author(s):  
Ashish Dhakal ◽  
Bikash Lal Shrestha ◽  
Sameer Karmacharya ◽  
Aakash Pradhan
Keyword(s):  
Hearing Loss ◽  
Gold Standard ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Neck Surgery ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Sectional Study ◽  
Cross Sectional

Introduction: The Hum Test is used by some otolaryngologists as an alternative to the Weber Test to detect the presence and type of acute hearing change; however, its use has not yet been formally validated. Objective: To compare the diagnostic performance of Hum test with Weber test to detect hearing loss taking pure tone audiometry as the gold standard. Methodology: A prospective, cross-sectional study was conducted in the department of Otorhinolaryngology and Head and Neck surgery, Dhulikhel Hospital- Kathmandu University Hospital, from June 2018 to February 2019. Total of 257 patients were enrolled in the study and were subjected to 3 tests: Weber test, Hum test, and pure tone audiometry. Results: When examining patients with hearing loss, sensitivity of Hum test and weber test were 60.3% and 93.8 % respectively. In patients with CHL, sensitivity of Hum test was 55.7% while Weber test was 94.8%. In SNHL, it was 74.6% for Hum test and 90.5% for Weber test. Likewise, according to laterality of disease, sensitivity of Hum test was 58.6% for unilateral hearing loss and 65.2% for bilateral hearing loss. For Weber test it was 96.3% for unilateral and 86.4% for bilateral disease. Conclusion: Hum test is not as sensitive as Weber test in diagnosis of hearing loss both for conductive and sensorineural hearing loss.

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

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

<p class="abstract"><strong>Background:</strong> 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).</p><p class="abstract"><strong>Methods:</strong> 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.  </p><p class="abstract"><strong>Results:</strong> 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.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p><p class="abstract"> </p><p> </p>

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.

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