Traumatic perforation: determinants of conductive hearing loss

Ravi K. S.; Ravishankar S. N.

doi:10.18203/issn.2454-5929.ijohns20172583

Authors

Ravi K. S. Department of ENT, AIMS, B G Nagar, Karnataka, India
Ravishankar S. N. Department of ENT, AIMS, B G Nagar, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20172583

Keywords:

Conductive hearing loss, pure-tone audiometry, traumatic tympanic membrane perforation

Abstract

Background: Traumatic perforations of the tympanic membrane are very common in day to day life and it may be due to direct or indirect source. The aim of this study is to evaluate the various factors which determine the degree of hearing loss in patients with traumatic perforation of tympanic membrane.

Methods: A retrospective review was performed in 50 patients seen at the ENT department in our rural tertiary center over a period of two years between January 2015 to December 2016. The patients with history of ear trauma from various causes and with absolutely no previous history of any ear disease were included in our study. The data retrieved included parameters such as age, sex, side, cause of injury and presenting complaints such as hearing loss, earache, tinnitus, and vertigo. A detailed clinical and otoscopic examination was done to determine the size and location of the perforation. Hearing was assessed using pure tone audiometry (PTA) to determine the degree of hearing loss and to correlate with frequency, size and location of perforation.

Results: A total of 50 patients with traumatic perforations of the tympanic membrane were enrolled for the study, comprising of 32 males and 18 females patients. Age of the patients ranged from12 to 65 years of age. The results showed that the most common mode of trauma was RTA (46%). Audiometry shows that the larger the tympanic membrane perforation, the larger the air–bone gap. Hearing loss was highest at the lowest frequencies and generally decreased as the frequency increased. The results also showed that there was no difference in air bone gap with relation to location of perforation (anterior vs. posterior).

Conclusions: The conductive hearing loss resulting from a tympanic membrane perforation is frequency dependent, with the largest losses occurring at the lowest sound frequencies, hearing loss increases as size of the perforation increases and no relation with location of perforation.

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Author Biography

Ravishankar S. N., Department of ENT, AIMS, B G Nagar, Karnataka, India

Resident

Department of ENT

References

Ott MC, Lundy LB. Tympanic membrane perforation in adults. How to manage, when to refer. Postgrad Med. 2001;110:81‑4.

Peter JK, Paul HK. Principle of trauma. In: Byron J, editor. Bailey Head and Neck Surgery - Otolaryngology. 3rd edn. Lippincott Williams and Wilkins Publishers; 2001.

Uppal KS, Singh R, Singh J, Popli SP. Closure of tympanic membrane perforations by chemical cautery. Indian J Otolaryngol Head Neck Surg. 1997;49(2):151–3.

Gulya AJ, Glasscock ME. Glasscock–Shambaugh surgery of the ear. 5th ed. Spain: BC Decker Inc; 2003: 400–420.

Griffin WL Jr. A retrospective study of traumatic tympanic membrane perforations in a clinical practice. Laryngoscope. 1979;89(2):261-82.

Gacek RR, Gacek MR. Anatomy of the auditory and vestibular systems. In: Snow JB Jr, Ballenger JJ, editors. Ballenger’s Otorhinolaryngology Head and Neck Surgery. 16th ed. Vol. 1. Ontario: DC Becker Inc; 2003: 1-5.

Berger G, Finkelstein Y, Harell M. Non‑explosive blast injury of the ear. J Laryngol Otol. 1994;108:395‑8.

da Lilly‑Tariah OB, Somefun AO. Traumatic perforation of the tympanic membrane in University of Port Harcourt Teaching Hospital, Port Harcourt. Nigeria. Niger Postgrad Med J. 2007;14:121‑4.

Wani A, Rehman A, Lateef S et al: Perforated eardrum: An overview. Indian Journal of Otology. 2016;22(2):100-4.

Voss SE, Rosowski JJ, Merchant SN, Peake WT. Middle-ear function with tympanic-membrane perforations: I—measurements and mechanisms. J Acoust Soc Am. 2001;110:1432–44.

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

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

Santhi T, Rajan KV. A study of closure of tympanic membrane perforations by chemical cauterisation. Indian J Otolaryngol Head Neck Surg. 2012;64(4):389–92.

Ahmad SW, Ramani GV. Hearing loss in perforations of the tympanic membrane. J Laryngol Otol. 1979;93:1091‑8.

Chun SH, Lee DW, Shin JK. A Clinical Study of Traumatic Perforation of Tympanic Membrane. Seoul, Korea: Department Of Otolaryngology, Hanil General Hospital. 2010;113:679-86.

Schuknecht HF. Pathology of the Ear. Philadelphia: Lea & Febiger; 1993.

Orji FT, Agu CC. Determinants of spontaneous healing in traumatic perforations of the tympanic membrane. Clin Otolaryngol. 2008;33:420‑6.