Hearing gain after tympanoplasty: a prospective study


  • Manzoor Ahmad Latoo Department of Otorhinolaryngology, Government Medical College, Srinagar, Jammu and Kashmir, India
  • Romesh Bhat Department of Otorhinolaryngology, Government Medical College, Srinagar, Jammu and Kashmir, India
  • Aleena Shafi Jallu Department of Otorhinolaryngology, Government Medical College, Srinagar, Jammu and Kashmir, India




Hearing gain, Tympanoplasty, Pure tone audiometry


Background: The aim of the present study was to determine hearing improvement in different types of tympanoplasties by comparing mean preoperative air bone (AB) gap with mean postoperative AB gap. The study focused on reconstruction of tympanic membrane and ossicular apparatus by tympanoplasty alone or tympanoplasty with mastoid surgeries (canal wall up or canal wall down).

Methods: 60 patients of either sex having chronic otitis media with conductive hearing loss of >20 dB were included in the study. Each patient had to undergo preoperative and postoperative pure tone audiometry to calculate average AB gap. Patients underwent tympanoplasty, with or without mastoid exploration depending on the disease status. Pure tone audiometry (PTA) was done at 3 months and 6 months and compared with pre-operative PTA.  

Results: Preoperatively PTA showed 29 (48.33%) patients had mild degree of hearing loss, followed by moderate degree of hearing loss in 18 (30.0%) patients. 10 (16.67%) patients had minimal hearing loss and moderately severe hearing loss was seen in 3 (5%) patients. Tympanoplasty alone was done in 52 patients (86.67%). Tympanoplasty with canal wall up mastoidectomy was done in 6 (10%) and tympanoplasty with canal wall down mastoidectomy was done in 2 (3.33%) patients. Type I tympanoplasty was performed in 37 (61.6%) patients, type-III tympanoplasty was the type of surgery in 15 (25.0%) patients. Type II and type IV tympanoplasties were performed in 4 (6.7%) patients each separately.

Conclusions: Hearing gain is better in type I tympanoplasty than in tympanoplasty type II, type III and type IV with or without mastoid surgeries.


Jung Timthy TK, Hanson J. Classification of Otitis Media and Surgical Principles. Otolaryngol Clin N Am. 1999;32(3):369-80.

Saha Ashok K, Munsi DM. Evaluation of improvement in hearing in Type-1 Tympanoplasty and its influencing factors. Indian J Otolaryngol Head Neck Surg. 2005;58(3):253-7.

Saminullah Chandra K. Combined effect of Eustachian tube function and middle Ear mucosa on Tympanoplasty. Indian J Otol. 2006;12:26-7.

George GB, Merchant SN, Kelly G, Swan IR, Canter R, Mckerrow WS. Chronic Otitis Media. In: Gleeson M, editor. Scott-Brown’s Otorhinolaryngol Head Neck Surg. 7th ed. London: Edward Arnold Publishers; 2008: 3397-3438.

Voss SE, Rosowskii JJ, Merchant SN, Peake WT. How do tympanic membrane perforations affect human middle-ear sound transmission. Acta Otolaryngol (Stockh). 2001;121:169-73.

Voss SE, Rosowskii JJ, Merchant SN, Peake WT. Middle ear function with tympanic membrane perforations II:A simple model. J Acoust Soc Am. 2001;110:1445-52.

Mehta RP, Rosowskii JJ, Voss SE, O’Neil E, Merchant SN. Determinants of hearing loss in perforations of the tympanic membrane. Otol Neurotol 2006;27:136-43.

Sismanis A. Tympanoplasty. In: Glascock ME 3rd, editor. Glasscock-Shambaugh Surgery of the Ear. 5th ed. Hamilton, Ontario: Decker BC, WB Saunders Company; 2003: 463-484.

Aslan FS, Islam A, Celik H, Demirci M, Samim E, Kose KS. The functional and anatomic results of Canal Wall down Tympanoplasty in extensive cholesteatoma. Acta Otolaryngol. 2009;129(12):1388-94.

Umpathy N, Dekker PJ. Myringoplasty: is it worth performing in children? Arch Otolaryngol Head Neck Surg. 2003;129:53-5.

Mudhol RS, Jaya KK. Descriptive study of complications of CSOM. Indian J Otol. 2000;12:34.

Islam MS, Islam MR, Bhuiyan MAR, Rashid MS, Datta PG. Pattern and degree of hearing loss in chronic suppurative otitis media. Bangladesh J Otorhinolaryngol. 2010;16(2):96-105.

Somashekara KG, Swathi RK, Nirwan S. A study of hearing improvement after tympanoplasty by means of pure tone audiometry. IJSR. 2014;3(12):2277-8179.

Shetty S. Pre-operative and Post-operative Assessment of Hearing following Tympanoplasty. India. J Otolaryngol Head Neck Surg. 2012;64(4):377-81.

Olowookere SA, Ibekwe TS, Adeosun AA. Pattern of tympanic membrane perforation in Ibadan:a retrospective study. Ann Ibadan Postgraduate Med. 2008;6(2):31-3.

Mondal S, Banerjee M, Das S. Evaluation of antimicrobial sensitivity pattern of chronic suppurative otitis media in a tertiary care hospital of West Bengal, India. Int J Basic Clin Pharmacol. 2017;6(4):891-4.

Yung MW. Myringoplasty:hearing gain in relation to perforation site. J Laryngol Otol. 1983;97:11-7.

Derlacki EL. Residual perforations after tympanoplasty: office technique for closure. Otolaryngol Clin North Am. 1982;15:861-7.

Payne MC, Githler FJ. Effects of perforations of the tympanic membrane on cochlear potentials. Arch Otolaryngol. 1951;54:666.

Sarker MZ, Ahmed M, Patwary K, Islam R, Joarder AH. Factors affecting surgical outcome of Myringoplasty. Bangladesh J Otorhinolaryngol. 2011;17(2):82-7.

Kolo ES, Ramalingam R. Hearing Results Post Tympanoplasty:Our Experience with Adults at the KKR ENT Hospital, India. Indian J Otolaryngol Head Neck Surg. 2012;66(4):365-8.

Babu MM, Ramabhadraiah AK, Srivastava T, Thirugnanmani R. Hearing improvement after type III tympanoplasty: a prospective observational study. Indian J Otolaryngol Head Neck Surg. 2019;71(2):1227-31.

Gupta S, Kalsotra P. Hearing gain in different types of tympanoplasties. Indian J Otol. 2013;19:186-93.

Muqtadir F, Rahul S. A study of hearing improvement gained after tympanoplasty using various methods in cases of CSOM. Int J Otorhinolaryngol Head Neck Surg. 2018;4(1):107-11.






Original Research Articles