Published: 2021-05-26

Role of pre-operative air-bone gap in outcome in tinnitus after undergoing type-1 tympanoplasty in patients with chronic suppurative otitis media

Manit M. Mandal, Ajay K. Panchal, Rakesh Kumar, Parth B. Kapadia


Background: Researches suggest middle ear surgery might improve tinnitus after tympanoplasty. Purpose of this study was to investigate association between pre-operative air-bone gap (ABG) and tinnitus-outcome after tympanoplasty type I.

Methods: 100 patients with tinnitus having more than 6 months of symptoms of chronic suppurative otitis media (CSOM) that were refractory to medical treatment were included in study. All patients were evaluated through otoendoscopy, pure-tone audiometry, questionnaire-based survey using the visual analogue scale (VAS) and tinnitus handicap inventory (THI) for tinnitus symptoms before and 4 months after tympanoplasty. Influence of preoperative bone conduction (BC), preoperative air-bone-gap and postoperative air-bone-gap on tinnitus outcome post-operatively was calculated.

Results: Patients were divided into two groups based on preoperative BC of <25 dB or >25 dB. Postoperative improvement of tinnitus in both groups showed statistical significance. Patients whose preoperative air-bone-gap was <15 dB showed no improvement in postoperative tinnitus using VAS (p=0.887) and THI (p=0.801). Patients whose preoperative air-bone-gap was >15 dB showed significant improvement in postoperative tinnitus using VAS (p<0.01) and THI (p=0.015). Postoperative change in tinnitus showed significance compared with preoperative tinnitus using VAS (p=0.006). Correlation between reduction in VAS score and air-bone-gap (p=0.201) or between reduction in THI score and air-bone-gap (p=0.270) was not significant.

Conclusions: Preoperative ABG can be a predictor of tinnitus outcome after tympanoplasty in CSOM with tinnitus.



Tinnitus, CSOM, Tympanoplasty, Interlay technique

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