Title: A Study of Evaluation of Hearing Loss in Tympanic Membrane Perforation and Hearing Outcome after Tympanoplasty

Authors: Dr V.P. Narve, Dr Vinay Gangwani, Dr Varsha Tripathi, Dr Deepak Parmar

 DOI: https://dx.doi.org/10.18535/jmscr/v7i4.148

Abstract

Aims and Objective: Assessment of effect of size, site, location of perforation on the degree of hearing loss. To evaluate improvement in hearing after tympanoplasty.

Methodology: This is the retrospective and prospective study of 100 patients that underwent tympanoplasty at tertiary care hospital between January 2106 to June 2018. The follow up period was 1 year.

Results: Most common type of perforation was medium type of perforation with incidence of 44%. Hearing loss was found to be maximum with large central perforation (49.7 ± 7.07 dB). Mean improvement gain after tympanoplasty was also maximum with large central perforation (15.67 dB).

Conclusion: The larger the size of perforation, the larger is the hearing loss. The location of perforation has significant effect on the degree of hearing loss with posterior quadrant perforations causing more hearing loss. Tympanoplasty is a beneficial procedure for hearing improvement and eradication of disease and there is significant improvement after tympanoplasty.

References

  1. Donaldson JA, Duckert LG. Anatomy of the ear. In: Paparella MM, Shumrick DA, editors. Otolaryngology.Basic sciences and related principles.3. Philadelhia: WB Saunders Company : 1991.
  2. Browning GG et al Scott-brown’s otorhinolaryngology head and neck surgery, 7th edn. 3:3421.
  3. Khan NA. Repair of traumatic perforation of tympanic membranes by a new technique. Pak J Otolaryngol. 1992;8:177–179.
  4. Adkins WY. Composite autograft for Tympanoplasty & tympanomastoid surgery. Laryngoscope. 1990;100:244-7.
  5. Committee on conservation of hearing of the American Academy of Ophthalmology and Otolaryngology. Standard classification for surgery of chronic ear disease.Arch Otolaryngol. 1965;81:204-5.
  6. Austin DF. Ossicular reconstruction.Arch Otolaryngol. 1971;94:525-35.
  7. Javed M, Khan S, Ullah H, Shah J. Onlay versus underlay myringoplasty, audiological results. Pak J Otolaryngol. 2000;16:59–60.
  8. Vrabec JT, Deskin RW, Grady JJ. Meta-analysis of pediatric tympanoplasty. Arch Otolaryngol.1999;125(5):530–534. doi: 10.1001/archotol.125.5.530.
  9. Ashfaq M, Aasim MU, Khan N. Myringoplasty: anatomical and functional results. Pak Armed Forces Med J. 2004;54
  10. Meyer AG, Albers FW et al (1997) Validation of hearing results in tympanoplasty. In: Huettenbrink (ed) Middle ear mechanics in researches and otosurgery.
  11. Rout MR, Des P, Mohanty D, Rao V, Susritha K, Jyothi BE. Ossicular chain defects in safe type of chronic suppurative otitis media. Indian J Otol 2014;20:102-5.
  12. Varshney S, Nangia A, Bist SS, Singh RK, Gupta N, Bhagat S. Ossicular chain status in chronic suppurative otitis media in adults. Indian J Otolaryngol Head Neck Surg 2010;62:621.
  13. Kashyap SK, Bhoopendra Singh, Purohit JP, Ajay Pratap Singh, MohdAzeem; Incidence of ossicular chain pathology in Tubotympanic CSOM. J of Evaluation of medical and Dental Sci, 2015; 4(67): 11701-7.
  14. Sharma M, Shetty D.P. Ossicular status in patients operated for chronic suppurative otitis media. Int J Res Rev 2016;4(9):1610-1616.doi:10.17511/ijmrr. 2016.i09.16.
  15. Kamal N, Joarder AH, Chowdhary AA, Khan AW. Prevalance of chronic suppurative otitis media among the children living in two selected slums of Dhaka City.Bangladesh Med Res Counc Bull. 2004 Dec;30(3):95-104
  16. Teja D D, Rhea P. Influence of Tympanic Membrane Perforation on Hearing Loss. Glob J Oto 2017; 5(5): 555673. DOI: 10.19080/ GJO.2017.05.555673.
  17. Gudepu P, Kesavan B, Kanchumurthy A. Comparative study of hearing loss with site and size of perforation. J. Evid. Based Med. Healthc. 2016;3(41),2035-2040.DOI: 10.18410/jebmh/2016/454.
  18. Palva T, Ramsay H. Myringoplasty and Tympanoplasty results related to training and experience. Clinical Otolaryngology and Allied Sciences.1995; 20:329-35.

Corresponding Author

Dr Vinay Gangwani

Post Graduate Student, Department of ENT Jaya Arogya Hospital, Gwalior, India