Clin Exp Otorhinolaryngol.  2015 Jun;8(2):92-96. 10.3342/ceo.2015.8.2.92.

Determinants of Conductive Hearing Loss in Tympanic Membrane Perforation

• Park H
• Hong SN
• Kim HS
• Han JJ
• Chung J
• Seo MW
• Oh SH
• Chang SO
• Lee JH

• KMID: 2360777
• DOI: http://doi.org/10.3342/ceo.2015.8.2.92

Abstract

OBJECTIVES
Tympanic membrane perforations are common, but there have been few studies of the factors determining the extent of the resulting conductive hearing loss. The aims of this study were to determine whether the size of tympanic membrane perforation, pneumatization of middle ear & mastoid cavity, and location of perforation were correlated with air-bone gap (ABG) of patients.
METHODS
Forty-two patients who underwent tympanoplasty type I or myringoplasty were included and preoperative audiometry were analyzed. Digital image processing was applied in computed tomography for the estimation of middle ear & mastoid pneumatization volume and tympanic membrane photograph for the evaluation of perforation size and location.
RESULTS
Preoperative mean ABG increased with perforation size (P=0.018), and correlated inversely with the middle ear & mastoid volume (P=0.005). However, perforations in anterior versus posterior locations showed no significant differences in mean ABG (P=0.924).
CONCLUSION
The degree of conductive hearing loss resulting from a tympanic membrane perforation would be expected with the size of perforation and pneumatization of middle ear and mastoid.

Keyword

Tympanic Membrane Perforation; Tympanoplasty

MeSH Terms

Audiometry
Ear, Middle
Hearing Loss, Conductive*
Humans
Mastoid
Myringoplasty
Tympanic Membrane
Tympanic Membrane Perforation*
Tympanoplasty

Figure

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  Fig. 1 Measurements of perforation ratio (B/A×100=22%; A, whole tympanic membrane; B, perforation).

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  Fig. 2 Measurement of area of middle ear and mastoid pneumatization in axial temporal bone computed tomography by M-view 5.4 software (Marotech, Seoul, Korea). It was measured as 334.48 mm2 in this cut (45.47+289.01=334.48).

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  Fig. 3 Relationship between perforation size and hearing. Perforation size had a significant effect on mean air-bone gap (ABG) in the current study. Error bars indicate ±2 standard errors of the mean for each marginal mean of mean ABG.

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  Fig. 4 Relationship between middle ear & mastoid pneumatization volume and hearing. Middle ear & mastoid pneumatization volume had a significant effect on mean air-bone gap (ABG) in the current study. Error bars indicate ±2 standard errors of the mean for each marginal mean of mean ABG.

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  Fig. 5 Relationship between perforation location and hearing. Perforation location did not have a significant effect on mean air-bone gap (ABG) in the current study. Error bars indicate ±2 standard errors of the mean for each marginal mean of mean ABG.

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