Reporting the benefits from middle ear surgery using the Glasgow Benefit Plot.

In the past, otologists have reported the results of middle ear surgery to improve hearing, either by tympanoplasty or by stapes surgery, mainly in terms of closure of the air-bone gap. This is valid as a measure of the technical success of the operation provided any change in the bone conduction thresholds, particularly at the higher frequencies, is also reported. Unfortunately, technical success in surgery does not always equate with patient benefit, primarily because, in most conditions, listening is a binaural condition. Disability in such circumstances is dictated by the hearing in the better hearing ear, which, quite correctly, is usually the nonoperated ear. Hence, it is important to define the relationship, before and after surgery, between the hearing in the operated and that in the nonoperated ear. This is the basis of the Glasgow Benefit Plot, which is drawn up from pure-tone audiometric data before and after surgery.