Tympanic membrane perforation: Its correlation with hearing loss and frequency affected - An analytical study

Nahata, Vijayshree; Patil, Chandrakant; Patil, Rashmi K; Gattani, Gaurav; Disawal, Ashish; Roy, Amitava

doi:10.4103/0971-7749.129796

Cited by 31 publications

(52 citation statements)

References 15 publications

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“…In this study, hearing loss was found to be more in posterior perforations, which was also observed by Maharjan et al, Nepal et al, Nahata et al, Bhusal et al 5,7,10 Contrary to this, Ibekwe et al, Mehta et al, Lerut et al and Pannu et al did not find significant difference in the hearing loss in anterior versus posterior quadrant perforations. 8,9,11,12 We found that the hearing loss resulting from ML was more than that of non-MLs.…”

Section: Discussionsupporting

confidence: 78%

Comparative assessment of hearing in various tympanic membrane perforations in patients at Bhuj, Kutch, Gujarat, India: a cross sectional study

Darad¹,

Sinha²

2017

Int J Otorhinolaryngol Head Neck Surg

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INTRODUCTIONChronic suppurative otitis media (CSOM) is an inflammation of a part or whole of the mucoperiosteal lining of the middle ear cleft. It is a highly prevalent disease of the middle ear. Although the incidence and prevalence of CSOM has decreased in recent decades, due to improving hygiene and treatment, it is still a major health problem in both developing and developed countries.1,2 The tympanic membrane (TM) emulates an irregular cone and is about 9 mm in diameter. It is firmly attached to the malleus at the lateral process and at the umbo. The middle ear couples sound signals from the ear canal to the cochlea chain. The major transformer mechanism within the middle ear is the ratio of the TM area to the stapes footplate area (the areal ration). The TM gathers force over its entire surface and then couples the gathered force to the small footplate of the stapes. Human TM has an area that is 20 times larger than the footplate, thus, if the transformer action of the areal ratio is "ideal," the sound pressure applied to the inner ear by the stapes footplate should be 20 times or 26 dB larger than the sound pressure at the TM. ABSTRACT Background:The objective of the present study was to correlate the size and site of perforation with hearing loss in chronic suppurative otitis media (CSOM). Methods: The cross sectional study was conducted among a purposive sample of first 100 consecutive patients of unilateral 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. Results: 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. Conclusions: 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.

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Section: Discussionsupporting

confidence: 78%

Comparative assessment of hearing in various tympanic membrane perforations in patients at Bhuj, Kutch, Gujarat, India: a cross sectional study

Darad¹,

Sinha²

2017

Int J Otorhinolaryngol Head Neck Surg

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“…1,2 Low frequencies shown affected more than high frequencies. The highest degree of hearing loss observed at frequency of 500 Hz while the lowest one at frequency of 4000 Hz (Table 2).This difference in degree of hearing loss was insignificant (p value=0.157).…”

Section: -38mentioning

confidence: 95%

“…The highest number of ears was seen in group I (36%), while the lowest number was seen in group IV (13.3%) (Figure 2). Nahata et al found that group III was most commonly involved (43%), while group I was most commonly involved (47%) in the study of Pannu et al 1,3 Site distribution: The site of tympanic membrane perforation divided into three categories according to its relation to the handle of malleus. Most of perforations were located centrally (62.7%) (Figure 3).…”

Section: Sa% and Hearing Lossmentioning

confidence: 99%

“…[1][2][3][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.…”

Section: Introductionmentioning

confidence: 99%

“…The present studies depend on comparing the mean of the degree of hearing loss of different site of perforation irrespective to the surface area of perforation. 1,3 There is a great bias in the above method because the result affected by the different surface area of perforation among these sites. We design a specific equation in order to overcome the above problem as shown in our study.…”

Section: Introductionmentioning

confidence: 99%

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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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Hearing loss increases with size but not site of tympanic membrane perforation in Aboriginal Australian children in remote locations

Morris

Lee

Sanchez

et al. 2022

Laryngoscope Investig Oto

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Objective: To investigate the effect of size, site, and activity of tympanic membrane (TM) perforation on hearing loss (HL) in Aboriginal and Torres Strait Islander (ATSI) children.Design: Observational study.Methodology: Children aged 5-18 years who identified as ATSI at seven Anangu community schools within the Anangu Pitjantjatjara Yankunytjatjara Lands and Maralinga Lands of South Australia underwent 4-frequency pure-tone audiometry (0.5, 1, 2, and 4 kHz) and video-otoscopy (VO). VO data was reviewed by surgeons for a middle ear diagnosis and VO files with TM perforations were then classified by perforation site (AS, AI, PS, PI, A, P, I) and size (<25%, 25%-50%, 50%-75%, or 75%-100%).Results: Five hundred seventy-five VO files with matching audiological data were obtained. Active perforations (35 dBHL; 28-44 IQR) demonstrated greater HL than inactive perforations (31 dBHL; 29-39 IQR) p = .0029. For inactive perforations there was a significant difference between <25% and all larger perforations (p < .0001) whereas for active perforations the significance changed to between <25% (p < .0001) and 25%-50% (p < .05) when compared to larger perforations.When perforation site was compared within all size/activity groups, no statistically different findings were identified. In all analyses, findings did not change when individual frequencies were compared to 4-frequency pure-tone average dBHL. Conclusion:In ATSI children from remote communities, HL is greater in ears with larger perforations and active middle ear disease but there was no relationship between perforation site and HL.Level of evidence: Level 4. Jack Morris and Zoe Lee are co-first authors.

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Tympanic membrane perforation: Its correlation with hearing loss and frequency affected - An analytical study

Cited by 31 publications

References 15 publications

Comparative assessment of hearing in various tympanic membrane perforations in patients at Bhuj, Kutch, Gujarat, India: a cross sectional study

Comparative assessment of hearing in various tympanic membrane perforations in patients at Bhuj, Kutch, Gujarat, India: a cross sectional study

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

Hearing loss increases with size but not site of tympanic membrane perforation in Aboriginal Australian children in remote locations

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