scholarly journals Study of effect of 1% sodium hyaluronate application on tympanic membrane perforation

2018 ◽  
Vol 4 (5) ◽  
pp. 1246
Author(s):  
Dimple Sahni ◽  
Bikramjit Singh ◽  
K. S. Uppal ◽  
Sanjeev Bhagat ◽  
Dinesh Sharma ◽  
...  
Keyword(s):  
Tympanic Membrane ◽  
Sodium Hyaluronate ◽  
Pure Tone Audiometry ◽  
Tympanic Membrane Perforation ◽  
Medium Size ◽  
P Value ◽  
Beneficial Effects ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation ◽  
Traumatic Origin

<p class="abstract"><strong>Background:</strong> Topical applications of hyaluronic acid have been found to have beneficial effects on closure of tympanic membrane perforations.<strong> </strong>The aim of the study was to evaluate the role of 1% sodium hyaluronate in the repair of small or medium sized dry central tympanic membrane perforation and improvement in hearing following closure of tympanic membrane perforation.</p><p class="abstract"><strong>Methods:</strong> 50 patients with dry central perforation of inflammatory or traumatic origin were taken up. Maximum of 4 applications of 1% sodium hyaluronate were given at weekly intervals. Final mapping for closure of tympanic membrane perforation and hearing assessment was done after 3 months.  </p><p class="abstract"><strong>Results:</strong> 26 perforations closed completely while 18 perforations showed significant reduction in size. Thus 44 or 88% perforations showed positive response to 1% sodium hyaluronate application. Hearing Improvement was observed on pure tone audiometry with the average hearing gain in patients after complete closure of tympanic membrane perforation was 12.40 dB with p value of 0.001.</p><p class="abstract"><strong>Conclusions:</strong> Study showed the beneficial effects of 1% sodium hyaluronate application in closure of small and medium size perforations of tympanic membrane perforation and improvement in hearing.</p><p class="abstract"> </p>

scholarly journals Hearing assessment and status of tympanic membrane pre and post-operated tympanoplasty in cases of CSOM.

2020 ◽  
Vol 27 (12) ◽  
pp. 2581-2585
Author(s):  
Tahir Hussain x Tahir Hussain Khan ◽  
Humaira Tahir ◽  
Imran Ali ◽  
Sohail Abdul Malik
Keyword(s):  
Tympanic Membrane ◽  
Pure Tone ◽  
Pure Tone Audiometry ◽  
Medium Size ◽  
P Value ◽  
Safe Procedure ◽  
Hearing Improvement ◽  
Middle Ear Mucosa ◽  
Tympanic Membrane Perforations ◽  
Hearing Assessment

Objectives: To compare assessment of hearing by PTA and status of tympanic membrane by oto-endoscope, pre-operative and post-operative tympanoplasty. Study Design: Retrospective/ Comparative study. Setting: Two different hospitals in Karachi. 1-Social Security Landhi Hospital Karachi. 2- Al-Tibri medical College & Hospital, Old Thana, Malir, Karachi. Period: July 2017 to June 2018. Material & Methods: 76 patients were included for this study with both genders who had dry tympanic membrane perforations. Age ranges between 18 to 40 years. Made two groups A (pre-operative and B (post-operative). In group-A, examined tympanic membrane perforations. 45 patients had small size (25%) perforations, 15 medium size (50%) and 16 subtotal (75%). Hearing assessment done by Pure tone Audiometry (PTA). After 1. 2 and 3 months post-tympanoplasty, examined grafted tympanic membrane and compared pre-operated status of tympanic membrane with post-operated status of tympanic membrane. PTA done after 3 months and compared it with pre-operated PTA. Results: Examination of tympanic membrane before tympanoplasty performed, perforations noted in all patients with different sizes in their tympanic membrane. PTA (pure tone audiometry) advised before tympanoplasty to all patients. Weber test performed on 1st post-operated day, it was lateralized towards operated ear which indicate the safety of inner ear. Post-operated 1, 2 and 3 months examined tympanic membrane with oto-endoscope. Intact grafted tympanic membrane seen in 70 patients after 1 months. After 2 months 72 patients had intact grafted tympanic membrane and after 3 months 73 patients out of 76 patients had intact grafted tympanic membrane. PTA also advised after 3 months of tympanoplasty and compared it with pre-operated pure tone audiometry (PTA). Air conduction (AC) decreased 15.39dB after tympanoplasty. AB-gap reduction 13.95dB seen in 73 patients which showed hearing improvement. P value is < 0.001 significant. Conclusion: Tympanoplasty is a good and safe procedure for hearing improvement by reduction of AB-gap as well as provide protection of middle ear mucosa from infections due to closure of perforations of tympanic membranes.

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 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 Hearing gain after myringoplasty in relation to the size of tympanic membrane perforation

2020 ◽  
Vol 25 (1) ◽  
pp. 54-59
Author(s):  
Sutanu Kumar Mondal ◽  
Ashim Kumar Biswas ◽  
Md Mahmudul Huq ◽  
Md Hasan Ali ◽  
Md Kamruzzaman ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Tympanic Membrane ◽  
Bone Conduction ◽  
Tympanic Membrane Perforation ◽  
Medium Size ◽  
Hearing Gain ◽  
Bone Conduction Threshold ◽  
Large Size ◽  
Membrane Perforation ◽  
Air Conduction

Objectives: To assess hearing gain after successful myringoplasty in relation to the size of tympanic membrane perforation. Methods: This cross-sectional study was done in the department of otolaryngology and head neck surgery, BSMMU, Sahbag, Dhaka during the period of January 2009 to December 2010.A total of 60 patients were under went myringoplasty operation after taking detailed history, clinical examination and investigation. Preoperative and postoperative hearing assessment was done. Analysed data presented by various tables, graphics and figures. Results: In case of small size perforation preoperative mean bone conduction threshold was 7.66 dB, mean air conduction threshold was 34.14 dB and mean air bone gap was 26.48 dB. In case of medium size perforation preoperative mean bone conduction threshold was 9.61 dB, mean air conduction threshold was 44.48 dB. Mean air bone gap was 34.87 dB. In case of large size perforation preoperative mean bone conduction threshold was 13.12 dB, mean air conduction threshold was 59 dB, and mean air bone gap was 45.88 dB. Hearing loss increases with increasing size of perforation. Ahmed and Rahim (1979) showed in the study that hearing loss increases with increasing the size of the perforation which was relevant in the study. After myringoplasty post-operative mean air bone gap was 21.24 dB in small size, 21.74 dB in medium sized and 24 dB in large size. From the record improvement of mean air bone gap or hearing gain was 5.24 dB in small size perforation respectively. The different of air bone gap closure between small and medium size perforation was statistically significant by unpaired’ test. Conclusion: Hearing gain after myringoplasty is better in large size perforation. Bangladesh J Otorhinolaryngol; April 2019; 25(1): 54-59

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 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.

Effect of tympanic membrane perforation on middle-ear sound transmission

2009 ◽  
Vol 123 (S31) ◽  
pp. 81-89 ◽  
Author(s):  
Y Matsuda ◽  
T Kurita ◽  
Y Ueda ◽  
S Ito ◽  
T Nakashima
Keyword(s):  
Image Analysis ◽  
Tympanic Membrane ◽  
Chronic Otitis Media ◽  
Tympanic Membrane Perforation ◽  
Conduction Disturbance ◽  
Low Frequencies ◽  
Tympanic Membrane Perforations ◽  
Precise Evaluation ◽  
Membrane Perforation ◽  
Sound Conduction

AbstractTympanic membrane perforation causes a sound conduction disturbance, and the size of this conduction disturbance is proportional to the perforation area. However, precise evaluation of perforation size is difficult, and there are few detailed reports addressing this issue. Furthermore, such evaluation becomes more difficult for irregularly shaped perforations. This study conducted a quantitative evaluation of tympanic membrane perforations, using image analysis equipment.A significant correlation was found between the degree of sound conduction disturbance and the perforation area; this correlation was greater at low frequencies following a traumatic perforation. The conductive disturbance associated with chronic otitis media was significantly greater at low frequencies. Circular perforations caused only minor conduction disturbance. Perforations in the anteroinferior quadrant were associated with greater conduction disturbance. Traumatic spindle-shaped perforations and malleolar perforations were associated with greater conduction disturbance.

scholarly journals Outcome of Myringoplasty in Underlay Technique

2019 ◽  
Vol 24 (2) ◽  
pp. 131-136
Author(s):  
Md Abdur Razzak ◽  
KM Mamun Murshed ◽  
AKMA Sobhan ◽  
Md Rakib Hossain ◽  
SM Nafeez Imtiaz
Keyword(s):  
Success Rate ◽  
Tympanic Membrane ◽  
Surgical Techniques ◽  
Neck Surgery ◽  
Tympanic Membrane Perforation ◽  
College Hospital ◽  
Medical College ◽  
Tympanic Membrane Perforations ◽  
Membrane Perforation ◽  
Age Range

Background: Myringoplasty is one of the surgical techniques for the management of chronic supportive otitis media with permanent perforation of tympanic membrane. It is defined as simple surgical repair of tympanic membrane perforation without doing ossicular reconstruction. Objective: To determine the success rate of myringoplasty and to examine whether the hearing improvement is a potential indication for surgery. Methods: This study was conducted in the Department of Otorhinolaryngology and Head and Neck Surgery, Shaheed Suhrawardy Medical College Hospital from January 2017 to December 2017 and 100 patients who underwent myringoplasty in this period were analyzed. About 100 patients with dry central tympanic membrane perforations of various size were included in this study Results: Myringoplasty was performed in 100 patients. Male were (45%) and females were (55%).Twenty one (7%) of them belonged to age group of 10-20 years, 31 (31%) were in the age range of 21-33 years, 38(38%) were the age range 31-40 years while 24 (24%) aged between 41-50 years with mean age of 26.32 ±S.D 9.59 years. Overall success rate of graft uptake was noted in 88 (88%) out of 100 cases Conclusion: Myringoplasty is a safe surgical procedure in achieving intact tympanic membrane and to improve the hearing loss. Therefore, underlay technique being technically simple should be preferred, but the ultimate decision about the technique to be employed depends on the surgeons preference and the site of perforation  Bangladesh J of Otorhinolaryngology; October 2018; 24(2): 131-136

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. 

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