Correlation of hearing impairment with site of tympanic membrane perforation

Bhusal, C L; Guragain, Rajendra; Shrivastav, Rakesh Prakash

doi:10.3126/joim.v27i2.394

Cited by 6 publications

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“…The findings were correlating with other studies, where in those studies have not included the attico-antral perforations in their study [3,4].…”

Section: Discussionsupporting

confidence: 90%

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Pre-Operative and Post-Operative Assessment of Hearing following Tympanoplasty

Shetty

2011

Indian J Otolaryngol Head Neck Surg

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Tympanoplasty is one of the ever evolving surgical procedures mainly aimed at restoring the hearing loss and eradication of middle ear disease. We have made an attempt to assess the hearing improvement of various types and techniques of tympanoplasty. A prospective observational study was done on 50 cases of CSOM, of which 45 cases were tubotympanic type, and 5 cases were attico-antral. Patients of only pure conductive component with good cochlear reserve and good Eustachian tube function were considered for the study. This study aims at assessing the hearing improvement with various types of tympanoplasty.

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“…The findings were correlating with other studies, where in those studies have not included the attico-antral perforations in their study [3,4].…”

Section: Discussionsupporting

confidence: 90%

“…It was observed that the greatest hearing loss was found in the big central perforation, whereas least in those of the anterior central perforations, which matched with other studies also [3,4].…”

Section: Discussionsupporting

confidence: 90%

Pre-Operative and Post-Operative Assessment of Hearing following Tympanoplasty

Shetty

2011

Indian J Otolaryngol Head Neck Surg

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“…This is in agreement with the experimental works of Voss et al 10 and Mehta et al, 13 who found no effect of location of perforations on the pressure difference at oval and round window and their clinical studies, also showed that there was no difference in HL in anterior and posterior perforations having the same middle ear volume. These observations are contrary to the results of Pannu et al, 16 Bhusal and Shrivastav, 20 Durko and Latkowski, 15 Nepal et al, 17 and Yung. 21 However, in our study, the medium-sized central perforations were found to have 7 to 9 dB greater mean HL than anterior or posterior perforations.…”

Section: Effect Of Site Of Perforationmentioning

confidence: 57%

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

Virk

Kudawla

Bansal

et al. 2019

AONO

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IntroductionThe 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 mm 2 ) 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 mm 2 ) 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.Abstract Keywords ► air-bone gap ► chronic otitis media ► various sites and sizes of perforation

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“…Bhusal et al found that the highest degree of hearing loss found in big central perforations (45±7.6 dB) then in posterior perforations (43.3±7 dB) and lowest in anterior perforations (31±3 dB). 7 The difference was insignificant between central and posterior perforations (p value > 0.05), but it was significant between anterior and that of central or posterior one (p value <0.05).…”

Section: 3mentioning

confidence: 86%

Relationship between tympanic membrane perforation and conductive hearing loss in patients with chronic otitis media

Ali

Al-Shareda

2017

Int J Otorhinolaryngol Head Neck Surg

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INTRODUCTIONThere is high incidence of conductive hearing loss caused by perforations of tympanic membrane in chronic otitis media. The results of studies regarding the effect of the size and the site of perforations on the degree of hearing loss conflicting.Some studies show a correlation between degree of hearing loss and the size of tympanic membrane perforation that larger perforation causes larger hearing loss.1-4 The weak point of these studies is the crude estimation of the size of tympanic membrane perforation. In our study, we use a program enable us to calculate the surface area of perforation precisely and designing a logarithmic equation between degree of hearing loss and surface area of perforation.The results of articles were conflicting about the effect of perforation site on the degree of hearing loss. The present studies depend on comparing the mean of the degree of hearing loss of different site of perforation ABSTRACT Background: 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. Methods: 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. Results: 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). Conclusions: 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.

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Correlation of hearing impairment with site of tympanic membrane perforation

Cited by 6 publications

References 0 publications

Pre-Operative and Post-Operative Assessment of Hearing following Tympanoplasty

Pre-Operative and Post-Operative Assessment of Hearing following Tympanoplasty

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

Relationship between tympanic membrane perforation and conductive hearing loss in patients with chronic otitis media

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