Comparative assessment of hearing in various tympanic membrane perforations in patients at Bhuj, Kutch, Gujarat, India: a cross sectional study
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20170932Keywords:
Hearing, Otorrhea, Perforation, Tympanic membraneAbstract
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.
References
Lin YS, Lin LC, Lee FP, Lee KJ. The prevalence of chronic otitis media and its complication rates in teenagers and adult patients. Otolaryngol Head Neck Surg. 2009;140:165‑70.
Bluestone CD. Studies in otitis media: Children’s Hospital of Pittsburgh‑University of Pittsburgh progress report‑2004. Laryngoscope. 2004;114(11):1‑26.
Merchant SN, Rosowski JJ. Acoustics and Mechanics of the middle ear. Glasscock-Shambaugh: Surgery of the ear. 6th edition. USA: People’s Medical Publishing House; 2010: 49-72.
Anthony WP, Harrison CW. Tympanic membrane perforation. Effect on audiogram. Arch Otolaryngol. 1972;95:506-10.
Maharjan M, Kafle P, Bista M, Shrestha S, Toran KC. Observation of hearing loss in patients with chronic suppurative otitis media tubotympanic type. Kathmandu Univ Med J (KUMJ). 2009;7:397‑401.
Bhusal CL, Guragain RP, Shrivastav RP. Size of tympanic membrane perforation and hearing loss. JNMA J Nepal Med Assoc 2006;45:167‑72.
Nepal A, Bhandary S, Mishra SC, Singh I, Kumar P. The morphology of central tympanic membrane perforations. Nepal Med Coll J. 2008;9:239‑44.
Ibekwe TS, Nwaorgu OG, Ijaduola TG. Correlating the site of tympanic membrane perforation with Hearing loss. BMC Ear Nose Throat Disord. 2009;9:1.
Mehta RP, Rosowski JJ, Voss SE, O’Neil E, Merchant SN. Determinants of hearing loss in perforations of the tympanic membrane. Otol Neurotol. 2006;27:136‑43.
Nahata V, Patil CY, Patil RK, Gattani G, Disawal A, Roy A. Tympanic membrane perforation: Its correlation with hearing loss and frequency affected – An analytical study. Indian J Otol. 2014;20:10-5.
Lerut B, Pfammatter A, Moons J, Linder T. Functional correlations of tympanic membrane perforation size. Otol Neurotol. 2012;33:379‑86.
Pannu KK, Chadha S, Kumar D, Preeti. Evaluation of hearing loss in tympanic membrane perforation. Indian J Otolaryngol Head Neck Surg. 2011;63:208-13.
Kharadi P, Prajapati V, Mehta K, Jha S, Pandya V. A study of correlation of size and site of perforation with deafness. Southeast Asian J Case Rep Rev. 2014;3:939-48.