Bob Lerut1, Alain Pfammatter, Johnny Moons, Thomas Linder. 1. Department of Otorhinolaryngology, Head and Neck Surgery, AZ Sint Jan Brugge-Oostende AV, campus Brugge, Bruges, West-Vlaanderen, Belgium. bob.lerut@azbrugge.be
Abstract
OBJECTIVE: The correlation between tympanic membrane perforations and hearing loss was studied. STUDY DESIGN: Prospective data from 220 patients, who underwent primary surgery for simple chronic otitis media with a perforated eardrum, were analyzed. SETTING: Tertiary referral center. PATIENTS: One hundred fifty-one patients with 155 eardrum perforations, which were checked for correct diagnosis, normal middle-ear status, and integrity of the ossicular chain, were included. INTERVENTIONS: All patients underwent primary myringoplasty. MAIN OUTCOME MEASURES: Preoperative conductive hearing loss due to eardrum perforations. RESULTS: Hearing loss shows a linear relationship with increasing eardrum perforation size. Umbo involvement shows a worsening of the hearing by 5 to 6 dB (p < 0.0001). The least impact of a perforation is seen at the resonance frequency of 2 kHz. Above and below 2 kHz, an 'inverted V shape' of the air-bone gap is a consistent finding. If the air-bone gap exceeds the 'inverted V-shape' pattern, additional pathology behind the eardrum must be assumed and addressed. CONCLUSION: We propose using standardized photographs or drawings to document preoperative perforation sizes. A linear relationship between the size of a perforation and the conductive hearing loss does exist. Umbo involvement at the perforation margin may worsen the hearing by 5 to 6 dB, whereas the position of the perforation itself does not play a role. The least impact of a perforation is seen at the resonance frequency of 2 kHz. An "inverted V-shape" pattern, above and below 2 kHz, of the air-bone gap is a consistent finding. If the air-bone gap exceeds this pattern, additional pathology behind the eardrum perforation must be assumed and addressed.
OBJECTIVE: The correlation between tympanic membrane perforations and hearing loss was studied. STUDY DESIGN: Prospective data from 220 patients, who underwent primary surgery for simple chronic otitis media with a perforated eardrum, were analyzed. SETTING: Tertiary referral center. PATIENTS: One hundred fifty-one patients with 155 eardrum perforations, which were checked for correct diagnosis, normal middle-ear status, and integrity of the ossicular chain, were included. INTERVENTIONS: All patients underwent primary myringoplasty. MAIN OUTCOME MEASURES: Preoperative conductive hearing loss due to eardrum perforations. RESULTS:Hearing loss shows a linear relationship with increasing eardrum perforation size. Umbo involvement shows a worsening of the hearing by 5 to 6 dB (p < 0.0001). The least impact of a perforation is seen at the resonance frequency of 2 kHz. Above and below 2 kHz, an 'inverted V shape' of the air-bone gap is a consistent finding. If the air-bone gap exceeds the 'inverted V-shape' pattern, additional pathology behind the eardrum must be assumed and addressed. CONCLUSION: We propose using standardized photographs or drawings to document preoperative perforation sizes. A linear relationship between the size of a perforation and the conductive hearing loss does exist. Umbo involvement at the perforation margin may worsen the hearing by 5 to 6 dB, whereas the position of the perforation itself does not play a role. The least impact of a perforation is seen at the resonance frequency of 2 kHz. An "inverted V-shape" pattern, above and below 2 kHz, of the air-bone gap is a consistent finding. If the air-bone gap exceeds this pattern, additional pathology behind the eardrum perforation must be assumed and addressed.
Authors: Xiaohui Lin; Sebastiaan W F Meenderink; Glenna Stomackin; Timothy T Jung; Glen K Martin; Wei Dong Journal: J Assoc Res Otolaryngol Date: 2021-02-16
Authors: Sung-Il Cho; Simon S Gao; Anping Xia; Rosalie Wang; Felipe T Salles; Patrick D Raphael; Homer Abaya; Jacqueline Wachtel; Jongmin Baek; David Jacobs; Matthew N Rasband; John S Oghalai Journal: PLoS One Date: 2013-07-01 Impact factor: 3.240