Association Between Hearing Loss with Site and Size of Tympanic Membrane Perforation: A Retrospective Study

 

Abstract

Background: Perforation of tympanic membrane decreases surface area and allows the sound waves to pass through middle ear directly. Size of perforation and severity of the hearing loss are related.

Aim: The present study was aimed to evaluate association between hearing loss with site and size of tympanic membrane perforation.

Methods: All patients between 15-60 years of age with chronic otitis media safe type attending to outpatient clinic of ENT, Bangalore Medical College over the period of one year were included in this hospital-based retrospective study. The patients with unsafe CSOM, mixed hearing loss, and refusal to participate in the study, were excluded.

Results: 52% patients aged between 21 and 30 years. Male to female ratio was 1.7:1. 53% patients belonged to average socioeconomic class. The most common symptom on presentation was decreased hearing present in all the patients followed by otalgia (38%), and headache (31%). Unilateral ear was affected in 82 patients in our study. In 9 patients, both ears were affected. Among 50% ears, size of perforation was 10-30 mm2 followed by 0-9 mm2 in 40% ears, and >30 mm2 in 10% patients. We also observed that the patients with higher perforation have an increase in hearing loss on PTA examination (P<.0001). Among 100 ears, the most common perforation site was central (70%) followed by antero-superior (19%), antero-inferior (15%), postero-inferior (9%), and postero-superior (3%). We also observed that median PTA frequency on postero-superior site was significantly higher than antero-superior, anterosuperior, and central site (P<0.01).

Conclusion: Hearing loss is directly related to the size of TM perforation, as the size increases hearing loss also increases.

Keywords:Chronic otitis media; tympanic membrane; hearing loss

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