Abstract
BackgroundIt is recognized that the size of tympanic membrane(TM) perforation is proportional to the magnitude of hearing loss, however, there is no clear consensus on the effect of the location (site) of the perforation on the hearing loss. Hence the study is set to investigate the relationship between the location of perforation on TM and hearing loss.MethodsA cross-sectional prospective study of consecutive adult patients with perforated TM conducted in the ENT clinic of University College Hospital Ibadan between January 1st 2005 and July 31st 2006. Instruments used for data collection/processing include questionnaires, video and micro-otoscopy, Pure tone audiometer, image J and SPSS packages.ResultsSixty-two patients (22-males, 40-females), aged 16–75 years (mean = 35.4 +/- 4) with 77 perforated ear drums were studied and 15(24.2%) had bilateral TM perforations, 21 (33.9%) right unilateral and 26(41.9%) left unilateral. The locations of the TM perforations were 60(77.9%) central, 6(9.6%) antero-inferior, 4(5.2%) postero-inferior, 4(5.2%) antero-superior and 3(3.9%) postero-superior respectively with sizes ranging from 1.51%–89.05%, and corresponding hearing levels 30 dB – 80 dB (59% conductive and 41% mixed). Fifty-nine percent had pure conductive hearing loss and the rest mixed. Hearing losses (dBHL) increased with the size of perforations (P = 0.01, r = 0.05). Correlation of location of perforations with magnitude of hearing loss in acute TM perorations was (P = 0.244, r = 0.273) and for chronic perforations (p = 0.047 & r = 0.31).ConclusionThe location of perforation on the tympanic membrane (TM) has no effect on the magnitude of hearing loss in acute TM perforations while it is significant in chronic ones.
Highlights
It is recognized that the size of tympanic membrane(TM) perforation is proportional to the magnitude of hearing loss, there is no clear consensus on the effect of the location of the perforation on the hearing loss
Some workers believe that there is no significant effect associated with location of the perforation.[5,7]. This divergent opinion, informed undertaking the study, set to investigate the relationship between the location of perforation on TM and the magnitude of conductive hearing loss with a view to contributing to the body of knowledge on this subject. Study design This is a cross-sectional prospective study conducted between January 2005 and July 2006 with a target population of consecutive adults, seen in the Ear Nose and Throat(ENT) clinic of the University College Hospital (UCH) Ibadan Nigeria, with tympanic membrane perforations
This suggests that the position of the TM perforations in acute TM perforations does not affect the resultant magnitude of conductive hearing loss
Summary
It is recognized that the size of tympanic membrane(TM) perforation is proportional to the magnitude of hearing loss, there is no clear consensus on the effect of the location (site) of the perforation on the hearing loss. A total absence of the tympanic membrane would lead to a loss in the transformer action of the middle ear.[5] The location of the perforation is believed by some schools of thought to have a significant effect on the magnitude of hearing loss.[6] For instance, posterior quadrant perforations are believed to be worse than the anterior ones because of the direct exposure of the round window to sound waves and perforations at or near the site of tympanic membrane attachment to manubrium have more severe effects than those of comparable size at different sites.[6] some workers believe that there is no significant effect associated with location of the perforation.[5,7] This divergent opinion, informed undertaking the study, set to investigate the relationship between the location of perforation on TM and the magnitude of conductive hearing loss with a view to contributing to the body of knowledge on this subject
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