scholarly journals The correlation between hearing loss and the site of eardrum perforation: about 260 cases

2019 ◽  
pp. 18-21
Author(s):  
Iziki O ◽  
Ahmadou A ◽  
Abdulhakeem B ◽  
Chbaata A ◽  
Rouadi S ◽  
...  

Introduction: Some authors have assumed that the hearing loss depends on the site and the size of the perforations, but the results were contradictory and inconclusive. The aim of this present study is to find correlation between hearing loss and the location of tympanic membrane perforation after a chronic otitis media. Materials and Methods: A retrospective study was conducted in our ENT department, university hospital Ibn Rochd Casablanca Morocco. Two hundred sixty patients were enrolled in this study with eardrum perforation and without any neurosensory hearing loss or middle/ inner ear diseases. Data processing and analysis were carried out with computer software SPSS. Results: Two hundred sixty patients (103 males, 157 females) with age range 8–67 years (mean = 35.9) were studied. Bilateral tympanic membrane perforations were seen in 84 patients (60%), unilateral perforation in 176 patients (68%). In the 260 patients, 253 eardrum perforations were caused by chronic otitis media. Only 7 cases were due to a traumatism. The tympanic perforation was posterior in 64 cases (24.6%), subtotal in 54 cases (20.8%), central in 49 cases (18.8%), anterior in 44 cases (16.9%), antero-superior in 1 case, antero-inferior in 23 cases (8.8%), postero-superior in 5 cases (1.9%), and postero-inferior in 10 cases (3.8%). The tympanic perforation was inferior in 10 cases (3.8%). Perforation’s sites on the tympanic membrane were correlated with the groups of average hearing loss. For anterior perforations the average loss was moderate in 52.3% and severe in 13.6%. For posterior perforations the average loss was moderate in 75%. For subtotal perforation, the percentage was equal for mild and moderate hearing loss. The average loss for anterior perforations was 41.93 dB. The average loss for posterior ones was 42.66 dB. Conclusion: The current study aimed to correlate the degree of hearing loss to the different site of perforation. From the present study we can tell that Hearing loss in chronic otitis media is independent of the site of eardrum perforation. Nevertheless, further studies are needed with a representative population to confirm our results. Keywords: Site of eardrum perforation; Hearing loss; Bone conduction

2018 ◽  
Vol 26 (1) ◽  
pp. 43-47
Author(s):  
Santosh U P ◽  
Sridurga J ◽  
Aravind D R

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. 


2021 ◽  
Vol VOLUME 9 (ISSUE 1) ◽  
pp. 19-23
Author(s):  
M Lavanya

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.


Author(s):  
Amjed H. Ali ◽  
Isam M. Alshareda

<p class="abstract"><strong>Background:</strong> Study performed to evaluate relationship between surface area of tympanic membrane perforation and degree of hearing loss and the effect of perforation site on that relationship in patients with chronic otitis media<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> Seventy-five perforated tympanic membranes from 63 patients aged between 14-45 years with inactive mucosal chronic otitis media included in this study. Rigid endoscope (0 degree) used to take an image for each perforation that analyzed by Autodesk Design Review 2013 program. Degree of hearing loss assessed by pure tone audiometry. Surface area of perforation classified into four groups according to its percentage. Perforation site categorized into three groups regarding its relation to handle of malleus. Data analysis carried out with SPSS program version 17<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> We studied 34 females and 29 males with different surface area and site of perforations. It observed that with increment of surface area of tympanic membrane perforation, the degree of conductive hearing loss increases (P value=0.000). This relationship expressed in a logarithmic equation. The mean hearing loss of posterior perforation was 1.7±0.5 dB for each 1% of perforation but in anterior perforation was 1.5±0.6 dB for each 1% of perforation (p value 0.185)<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> In chronic otitis media, there is a quantitative logarithmic relationship between surface area of tympanic membrane perforation and degree of conductive hearing loss. The site of perforation does not play a significant role in determining degree of conductive hearing loss<span lang="EN-IN">.</span></p>


2020 ◽  
Vol 25 (1) ◽  
pp. 54-59
Author(s):  
Sutanu Kumar Mondal ◽  
Ashim Kumar Biswas ◽  
Md Mahmudul Huq ◽  
Md Hasan Ali ◽  
Md Kamruzzaman ◽  
...  

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


2019 ◽  
Vol 02 (01) ◽  
pp. 10-15
Author(s):  
Ramandeep Singh Virk ◽  
Krishan Kudawla ◽  
Sandeep Bansal ◽  
Ramya Rathod ◽  
Samarendra Behera

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.


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