Hearing Loss in Children After Tympanic Membrane Perforation: Cluster Analysis of 27 Cases

Abstract

Introduction: Tympanic membrane perforation (TMP) may be caused by several factors but commonly leads to conductive hearing loss. This study aims to characterize the profiles of hearing loss in pediatric patients with TMPs. Material and methods:A retrospective analysis of the medical charts of 27 patients was conducted. Otoscopy of the TM was done and pure tone audiometry was used to assess hearing loss. Cluster analysis was applied to evaluate the profiles of hearing loss and to find possible relations between profiles of hearing loss and the location of the perforation on the TM.Results: Cluster analysis revealed three types of hearing loss. The mean hearing loss in cluster 1 (6 cases) was above 30 dB, mainly as the result of perforation after chronic otitis media. Hearing loss in clusters 2 (9 cases) and 3 (12 cases) was less than 30 dB. In cluster 2 the perforation was mostly located in the posterior quadrants, while in cluster 3 it was most commonly in the inferior quadrants. In clusters 2 and 3, perforation was usually caused by slap of the open hand, injury, or past ventilation tube.Conclusions: Three different profiles (clusters) of hearing loss resulting from TMP were identified. Force of injury, etiology of the injury, and inflammation produce different sizes of perforations. Conductive hearing loss increases with perforation size and is independent of TM location. In general, hearing loss classification methods have the potential to improve diagnostic procedures, surgery, and rehabilitation of patients with TMPs.