Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-27T22:26:01.576Z Has data issue: false hasContentIssue false

Effects of location, size and shape of tympanic membrane perforations on hearing: analysis of 400 cases

Published online by Cambridge University Press:  20 September 2021

M K Balcı*
Affiliation:
Department of Otorhinolaryngology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
A İşlek
Affiliation:
Department of Otorhinolaryngology, Nusaybin State Hospital, Mardin, Turkey
Y B Bakiş
Affiliation:
Department of Otorhinolaryngology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
H K Önal
Affiliation:
Department of Otorhinolaryngology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Turkey
*
Author for correspondence: Dr M K Balcı, Department of Otorhinolaryngology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, Basın Sitesi Mh. Karabağlar, İzmir35170, Turkey E-mail: [email protected]

Abstract

Objective

This study aimed to evaluate the effect of size, location and shape of tympanic membrane perforations on hearing levels of a large study group treated in a tertiary referral centre.

Method

Medical data of 458 patients with tympanic membrane perforations were evaluated.

Results

A total of 336 patients had normal middle-ear findings during the surgical procedures. There was a significant difference in terms of mean pure tone average and air–bone gap values between posterior-inferior and anterior-inferior perforations (p = 0.005 and p = 0.044, respectively). The mean air–bone gap value of kidney-shaped perforations was significantly higher. Posterior-superior and posterior perforations were significant indicators for ossicular chain defects (p < 0.001; odds ratio, 14.2 and p = 0.004; odds ratio, 3.4, respectively).

Conclusion

Perforations located in the posterior-inferior quadrant caused the greatest hearing loss. The difference between posterior-inferior and anterior-superior or inferior perforations was statistically significant. Posterior perforations had a significant relationship with ossicular chain pathologies. Kidney-shaped perforations caused higher pure tone average and air–bone gap values than annular, elliptical or pinpoint perforations.

Type
Main Articles
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr M K Balcı takes responsibility for the integrity of the content of the paper

References

Mehta, RP, Rosowski, JJ, Voss, SE, O'Neil, E, Merchant, SN. Determinants of hearing loss in perforations of the tympanic membrane. Otol Neurotol 2006;27:136–43CrossRefGoogle ScholarPubMed
Pannu, KK, Chadha, S, Kumar, D, Preeti, . Evaluation of hearing loss in tympanic membrane perforation. Indian J Otolaryngol Head Neck Surg 2011;63:208–13CrossRefGoogle ScholarPubMed
Choffor-Nchinda, E, Djomou, F, Meva'Abiouele, RC, Mindja, D, Bola, A, Kewe, I et al. Determinants of hearing loss severity in tympanic membrane perforations in a sub-Saharan African setting. J Laryngol Otol 2018;132:1013–17CrossRefGoogle Scholar
Carpenter, DJ, Tucci, DL, Kaylie, DM, Frank-Ito, DO. The anatomic determinants of conductive hearing loss secondary to tympanic membrane perforation. J Otol 2017;12:125–31CrossRefGoogle ScholarPubMed
Voss, SE, Rosowski, JJ, Merchant, SN, Peake, WT. Middle-ear function with tympanic-membrane perforations. II. A simple model. J Acoust Soc Am 2001;110:1445–5210.1121/1.1394196CrossRefGoogle ScholarPubMed
Gaur, S, Sinha, ON, Bhushan, A, Batni, G. Observations on tympanic membrane perforations (safe type) and hearing loss. Indian J Otolaryngol Head Neck Surg 2017;69:2934CrossRefGoogle ScholarPubMed
Rana, AK, Upadhyay, D, Yadav, A, Prasad, S. Correlation of tympanic membrane perforation with hearing loss and its parameters in chronic otitis media: an analytical study. Indian J Otolaryngol Head Neck Surg 2020;72:187–93CrossRefGoogle ScholarPubMed
Voss, SE, Rosowski, JJ, Merchant, SN, Peake, WT. How do tympanic-membrane perforations affect human middle-ear sound transmission? Acta Otolaryngol 2001;121:169–73Google ScholarPubMed
Park, H, Hong, SN, Kim, HS, Han, JJ, Chung, J, Seo, MW et al. Determinants of conductive hearing loss in tympanic membrane perforation. Clin Exp Otorhinolaryngol 2015;8:92–6CrossRefGoogle ScholarPubMed
Lerut, B, Pfammatter, A, Moons, J, Linder, T. Functional correlations of tympanic membrane perforation size. Otol Neurotol 2012;33:379–86CrossRefGoogle ScholarPubMed
Aslier, M, Ozay, H, Gurkan, S, Kirkim, G, Guneri, EA. The effect of tympanic membrane perforation site, size and middle ear volume on hearing loss. Turkish Arch Otorhinolaryngol 2019;57:8690CrossRefGoogle ScholarPubMed
Voss, SE, Rosowski, JJ, Merchant, SN, Peake, WT. Middle-ear function with tympanic-membrane perforations. I. Measurements and mechanisms. J Acoust Soc Am 2001;110:1432–44CrossRefGoogle ScholarPubMed