A study on correlation of size and site of tympanic membrane perforation with degree of conductive hearing loss in chronic otitis media

Nikhil Mathew John, Karthik Shamanna, Allen Joe Rodrigues


Background: The objective of the study was to evaluate the size and site of tympanic membrane perforation, to assess hearing loss in patients with dry tympanic membrane perforation and to correlate the relationship between degree of conductive hearing loss with the size and site of tympanic membrane perforation.

Methods: Study (n=150) done to correlate the site and size of tympanic membrane perforations and conductive hearing loss in cases of inactive tubotympanic COM from October 2013 to December 2015. Size of the tympanic membrane perforation was assessed under microscope using a measuring template. Patients were divided into four groups according to size; based on the site: anterior group, posterior group, combined group and divided in to three groups based on the duration of the disease.  

Results: Anterior perforations were most common 74 (49.3%). Hearing loss increased as the size of the perforation increased IV>III>II>I [(46.97±6.59)>(38.69±2.63)>(35.13±2.98)>(27.67±1.85) p<0.0001)]. Statistical significance for hearing loss at combined site (41.37±5.9) was higher compared to Posterior (35.21±4.6, p=0.0001) and Anterior (31.7±5.7, p=0.0001). There was statistically significant difference in hearing loss between all three groups (p=0.0001). Degree of hearing loss increased as the duration of the disease increased.

Conclusions: Hearing loss is directly proportional to the size of perforation; more for the posterior quadrant perforations when compared to the anterior quadrant perforations of same size; also, hearing loss increases as the duration of the disease process increases.


Hearing loss, Perforation, Tympanic membrane

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