Size Of Perforation Research Articles

Experimental and Numerical Study of Optimization of Perforated Ribs Geometry and Configuration Using Taguchi Approach

ABSTRACTThe present experimental and computational investigation considers the optimization of solar air heaters (SAHs) with perforated ribs to simultaneously enhance the Nusselt number (Nu) and minimize pressure losses. This study introduces a novel approach by utilizing the Taguchi method to optimize geometric parameters, enabling efficient evaluation of heat transfer and pressure drop interplay for improved solar air heater performance. The effects of relative rib height (e/D), rib pitch (p/e), perforation diameter (d/e), and the number of perforations (n) were investigated using the finite volume method. A three‐dimensional, steady‐state, symmetric, and turbulent flow based on the k−ω SST turbulence model was employed, with optimization conducted using the Taguchi method. The analysis was performed at a Reynolds number (Re) of 18,000. The complex influence of perforation geometry on heat transfer and flow characteristics underscores the challenge of balancing performance parameters. Larger perforation diameters and optimized rib spacing reduced pressure drops by weakening recirculation zones and promoting uniform flow, while also enhancing local heat transfer. The optimal configuration (e/D = 0.11, p/e = 20, d/e = 0.7, n = 2) achieved a 41% improvement in thermal‐hydraulic performance. Increasing the perforation size (d/e) improved heat transfer up to a threshold of d/e = 0.7. Beyond this point, the turbulence intensity decreases and improvement in heat transfer ceases. The findings provide a practical framework for designing energy‐efficient SAHs by systematically evaluating geometric parameters and offer new insights into balancing heat transfer and pressure loss, contributing to advancements in renewable energy and thermal management.

Laparoscopic-assisted Polypectomy: A Promising Minimally-invasive Solution for Endoscopically Irresectable Polyps in Children.

Laparoscopic-assisted Polypectomy: A Promising Minimally-invasive Solution for Endoscopically Irresectable Polyps in Children.

Preliminary results of a new endoscopic underlay cartilage tympanoplasty with lateral malleolar flap.

A new endoscopic tympanoplasty technique for large and medium-sized central perforations via a transcanal approach, without tympanomeatal flap elevation compared the preliminary postoperative graft success and hearing outcomes with other techniques in the literature. The study involved 75 patients aged 12 to 44 who underwent tympanoplasty with the lateral malleolar flap technique from 2014 to 2017. Pre-operative otoscopy recorded perforation sizes, and pure tone averages were calculated at 500, 1000, 2000, and 4000Hz. The procedure was performed under general anesthesia via a transcanal approach using tragal cartilage, without tympanomeatal flap elevation. A control otoscopy was conducted six months post-operation to assess reperforation and graft position. Pure tone averages were measured, and pre-operative and post-operative audiological values were compared. Post-operative six-month graft success rate was 94.6%. Reperforation was observed in one patient (1.3%), while another patient (1.3%) exhibited lateralization, and two patients (2.6%) demonstrated medialization. The pre-operative mean hearing level was recorded at 33.3 ± 7.0 dB, accompanied by an Air-Bone Gap (ABG) of 24.0 ± 6.6 dB. Post-operative measurements indicated an improvement in these values, with the mean hearing level decreasing to 18.0 ± 4.8 dB and the ABG reducing to 16.3 ± 5.3 dB (p < 0.05). The endoscopic underlay cartilage tympanoplasty with lateral malleolar flap is a safe technique that avoids elevating the tympanomeatal flap. It offers shorter operation time, easier postoperative dressing, and high graft success rates similar to other tympanoplasty techniques.

Postoperative Infection in Myringoplasty: Impact of Surgical Technique and Timing of Infection.

We analyzed ear-related factors contributing to postoperative infections after myringoplasty. We also examined the association between the timing of postoperative infections and graft success. This retrospective study reviewed clinical data and operative records of patients with chronic tympanic membrane (TM) perforations who underwent myringoplasty. Factors influencing postoperative infection, including surgical techniques, perforation size, external auditory canal (EAC) packing, prophylactic antibiotic type, and the application of topical antibiotic cream, were assessed. In addition, the relationship between the timing of postoperative infection and graft failure was evaluated. Postoperative infection time was categorized as 1, 2, 3, or 4 weeks postoperatively. In total, 263 patients with chronic TM perforations underwent myringoplasty. The overall postoperative infection rate was 12.2% (32/263). The modified over-underlay approach was associated with a postoperative infection rate of 19.0%, in contrast to 11.1% for the conventional over-underlay technique and 8.9% for the underlay technique (P = .081). No significant differences in postoperative infection rates were identified among the NasoPore packing group (10.9%), the erythromycin cream group (19.4%), and the no-packing group (11.9%) (P = .418). Similarly, no significant differences were observed between prophylactic antibiotic type (11.2% vs 12.2% vs 25.0%, P = .373) or between the patients with and without topical antibiotic ointment (12.4% vs 10.3%, P = .986). Among the 32 patients with postoperative infections, 21.9% achieved graft success, whereas 78.1% experienced graft failure. Graft success rates were 71.4% (5/7), 9.1% (2/22), and 0.0% (0/3) at 1, 2, and 3 weeks postoperatively, respectively (P < .01). Our findings suggest that prophylactic antibiotic type, perforation size, the use of topical erythromycin cream, and EAC packing do not significantly influence postoperative infection. However, the surgical technique may affect the risk of postoperative infection. In addition, the timing of postoperative infection may influence graft failure.

3D Model Construction and Biomechanical Analysis of Temporomandibular Joint Disc Perforation Based on Arthrography.

3D Model Construction and Biomechanical Analysis of Temporomandibular Joint Disc Perforation Based on Arthrography.

Endoscopic versus microscopic tympanoplasty: A prospective randomized comparison of outcomes

Background/Aim: There is a limited number of systematic comparisons and comprehensive studies on auditory outcomes, graft success, and complication rates between traditional microscopic and newer endoscopic tympanoplasty techniques. Hence, we aim to compare these two techniques, namely endoscopic and microscopic type-1 tympanoplasty, in terms of anatomical and functional outcomes. Methods: This prospective randomized clinical trial included 40 adult patients, divided equally between those undergoing microscopic and endoscopic tympanoplasty. To eliminate selection bias, the sequence of operations alternated between the two methods based on the patients’ arrival order. Each patient’s pre-operative conditions and outcomes 6 months post-surgery were evaluated using pure tone audiometry tests and assessments of the tympanic membrane. For both groups, the tragal perichondrial cartilage composite graft served as graft material. Functional assessments evaluated the air conduction threshold and bone conduction threshold averages at frequencies of 500, 1000, 2000, and 4000 Hz, both pre-operatively and 3 months after the operation. Air conduction gain was determined by comparing the air bone gap at application with that 6 months post-surgery. The size of the tympanic membrane perforation was calculated as a percentage of the total area using ImageJ, and the correlation with functional gain was assessed. The condition of the tympanic membrane and graft position were documented 6 months post-surgery using IBM SPSS Statistics Version 26. Results: We compared mean (standard deviation [SD]) pre-operative air conduction threshold values between the endoscopic group (30.11 [5.19]) and the microscopic group (28.45 [5.19]) and found no significant difference (P=0.404). Similarly, we found no significant difference (P=0.169) in pre-operative air bone gap values between the endoscopic group (24.58 [5.35]) and the microscopic group (27.17 [6.34]). Post-operative air conduction threshold values in the endoscopic group (17.09 [11.28]) and the microscopic group (13.55 [7.99]) also showed no significant difference (P=0.258). The same was true for post-operative air bone gap values in the endoscopic group (13.97 [10.91]) and the microscopic group (9.63 [7.83]) (P=0.156). The average air conduction gain, an indicator we used to evaluate the functional success of the surgery, was similarly non-significant between the endoscopic group (13.08 [7.47]) and the microscopic group (14.90 [5.04]) (P=0.395). Conclusion: Our study findings suggest that an endoscope is at least as effective as the microscopic method in type-1 tympanoplasty. Moreover, with advantages like reduced surgical time and broad-angle viewing capabilities, the endoscopic method is poised to gain popularity.

Are polydioxanone plates combined with temporoparietal fascia the best technique for repair of nasal septal perforation?

Background The repair of nasal septal perforations is challenging. Interposition of polydioxanone (PDS) plates combined with fascia graft have been described in the literature with high success rates. Aims This study aims to present a case series on the closure of nasal septal perforation using this technique and to evaluate its outcomes. Material and methods Retrospective evaluation of patients who underwent surgical repair of nasal septal perforations with interposition fascia graft and PDS plates from 2020 to 2023. Results Nine patients were evaluated, 66.7% were male and the mean age was 40.7 years. The perforation size ranged from 0.9 to 4.5 cm (largest diameter). All procedures were performed by an open approach and all patients received interposition grafts of PDS plates – eight cases combined with a temporoparietal fascia graft and one combined with a rectus abdominis muscle fascia graft. Eight patients (88.9%) achieved complete closure of the perforation. No other complications were reported. Conclusions and significance Interposition temporoparietal fascia graft combined with PDS plates could be a highly effective technique, demonstrating good functional and anatomic outcomes with low morbidity at the donor site. This composite can be applied to small and large perforations as surgical success does not appear to be affected by the defect size.

Endoscopic transcanal butterfly cartilage myringoplasty outcome; which parameters affect long-term results?

Background Endoscopic transcanal butterfly cartilage myringoplasty is a prominent procedure because surgeons can perform this operation without elevating the transmeatal flap. Objective To evaluate factors that affect endoscopic butterfly cartilage myringoplasty regarding graft success and hearing improvement and determine long-term outcomes. Materials and methods This study included 86 patients who underwent surgery. The rates of graft success and hearing improvement were investigated, together with the effects of sex, age, operated side, and size and location of the perforation. Results The overall graft success was 83.7%. There was a statistically significant difference between pre- and post-operation in terms of hearing improvements at 0.5, 1, and 2 kHz (p < 0.001). Sex, age, operative side, and perforation size did not significantly affect graft success or hearing improvement (p > 0.05). The perforation location was significantly associated with graft success (p < 0.05). However, the location of the perforation did not significantly affect hearing improvement (p > 0.05). Conclusions Endoscopic transcanal butterfly cartilage myringoplasty can be performed with a high graft success rate and improved hearing. However, surgeons should be more careful when treating patients with posterior perforations. Significance The location of the perforation is significantly related to graft success.

Comparison of Graft Uptake in Perforated Eardrums with and without Myringosclerosis: A Prospective Case-control Study in a Tertiary Centre.

Introduction Various factors have been reported to affect the rates of success after tympanoplasty, among them, myringosclerosis. However, there are few studies focusing only on the effect of myringosclerotic plaque removal on tympanoplasty outcomes. Objective To compare the outcome of tympanoplasty in perforated eardrums with and without myringosclerosis. Methods The study included patients aged between 21 and 53 years diagnosed at the outpatient department with inactive mucosal chronic otitis media. The sample was divided into the case group, which included subjects with tympanic membrane perforation and myringosclerosis, and the control group, which included subjects with tympanic membrane perforation only, without myringosclerosis. We assessed the audiological findings of the patients before and after surgery, as well as hearing gain, graft uptake, and residual perforation/reperforation. Results No significant relationships were observed involving the age or sex of the patient and the closure rate or hearing gain, neither between the location of the perforation and graft uptake. Graft uptake was higher in patients with perforation size < 50%. The graft uptake and hearing gain were higher in the case group. Conclusion The removal of sclerotic plaques increases the surface of the raw area created by subepithelial excision of the myringosclerotic plaques, leading to a high rate of surgical success for the closure of tympanic membrane defects with coexisting myringosclerosis.

Butterfly Cartilage Inlay Technique for Repairing Medium-to-Large-Sized Tympanic Membrane Perforations.

Butterfly Cartilage Inlay Technique for Repairing Medium-to-Large-Sized Tympanic Membrane Perforations.

A Newly Discovered “Bull Head Amulet” from Tell El-Farkha, Egypt

In 2022, a new object fitting the so-called “bull head amulets” category was discovered at Tell el-Farkha in layers related to the late Predynastic period (Naqada IID2-IIIA, hereafter abbreviated as NIID2-NIIIA). Although the object displays all the typical features of the “amulets”, it also possesses some unique characteristics, such as its unusual size and lack of perforation, suggesting its use as a figurine rather than a pendant. Furthermore, the Tell el-Farkha item was discovered in a well-recorded settlement context, proving that such “amulets” do not necessarily belong to burial activities. Apart from the presentation of the find and its place of origin, a more general discussion on this interesting type of early Egyptian item raises various questions about their actual function, significance or interpretation.

Endoscopic septal perforation repair by endonasal flap: a technique using mobilized septal bone or cartilage for support.

Septal perforation refers to a defect within the nasal septum, which subsequently creates communication between the two nasal cavities. More than one surgical approach has been described to repair nasal septal perforations; however, they have a high rate of complication. We aim to introduce a new technique of endoscopic repair of septal perforations, which supports the flap and is thus used to prevent commonly encountered complications. This is a prospective cohort study with 40 patients who underwent thorough clinical examination, including nasal endoscopy, to determine the perforation details. This was followed by computed tomography (CT) scans and blood tests, which were done to exclude granulomatous disease, tumours, base of skull defects, polyps, etc. This new technique uses either a piece of cartilage alone or cartilage combined with a bone to support the flap. In the assessment, the perforation sizes were categorized, and a treatment plan was made for each. The patients in the study were evaluated, and their most common complaint was crusting. Most patients with less than 1cm perforations did not need support; the majority of those with 1-2cm perforations required cartilage support, and 2-3cm perforations required cartilage and bone support. We have proposed a new endoscopic technique that involves using cartilage and bone grafts to support the flaps used for nasal septal perforation repair and reduce the risk of associated complications.

Numerical Investigation of Water Transport and Effective Electrical Conductivity in Perforation of Gas Diffusion Layer Using Lattice Boltzmann Method

In polymer electrolyte membrane fuel cells, the gas diffusion layer (GDL) is composed of porous media and serves a critical role as a mass transport layer, facilitating reactant gas diffusion, removal of water generated in the catalyst layer, and electron transport. Artificial spacings known as perforations can be introduced to improve water management within this mass transport system. However, the impact of these perforations on the effective electrical conductivity has not been adequately studied. This study employs numerical methods to investigate water management and effective electrical conductivity in the presence of perforations, aiming to provide indicators for optimal design. The pseudopotential lattice Boltzmann method is utilized, which is particularly advantageous for modeling two-phase flow and electron transport in complex geometries. Using this numerical approach, we analyze water penetration in GDL structures and effective electrical conductivity based on electric potential fields focusing on geometric parameters such as the perforation size. Our results demonstrate a relationship between water management efficiency and effective electrical conductivity, suggesting the existence of an optimal perforation diameter. Moreover, when there is a water-induced penetration pattern due to the perforated structure, both the effective electrical conductivity and water management are enhanced at a lower porosity of the GDL structure.

Efficacy Analysis of Endoscopic Type 1 Tympanoplasty for Chronic Suppurative Otitis Media with Otomycosis.

Objective: To analyze the clinical effect of tympanoplasty performed for chronic suppurative otitis media (CSOM) patients with otomycosis under the oto-endoscope. Methods: A retrospective analysis was conducted on the healing of the tympanic membrane and hearing improvement of 431 CSOM patients who underwent endoscopic type 1 tympanoplasty. The patients with CSOM were divided into the control group (n = 203, without otomycosis) and the trial group (n = 184, with otomycosis). The patients were followed up for at least 3 months. The graft uptake rate and hearing improvement were compared. Results: The graft uptake rate was 94.57% (174/184) in the trial group and 96.06% (195/203) in the control group, indicating no significant difference between the 2 groups. The preoperative and postoperative average air-conduction hearing thresholds of CSOM with otomycosis were 42.68 ± 11.46 dBHL and 33.01 ± 11.51 dBHL, respectively (P = .000). Mean air-bone gap (ABG) reduction values were 3.96 ± 7.20 dBHL and 3.34 ± 7.96 dBHL, respectively. There was no significant difference in the average ABG (P = .420) and average air-conduction hearing threshold (P = .649) between the trial group and the control group after operation. The culture results of the CSOM group with otomycosis showed that the most common fungal genus was Aspergillus (87/173), with 32 cases of mixed infection of fungi and bacteria, and the most common mixed infection of bacteria was Staphylococcus epidermidis (9/32). The failure graft uptake was noticed in 8.8% (5/57) cases in the trial group with postoperative fungal infection and 3.9% (5/127) without otomycosis (P = .289). No significant difference was found in the successful healing rate among age, duration, perforation size, fungal type, postoperative fungal infection. Conclusion: CSOM with otomycosis is not a contraindication for endoscopic type 1 tympanoplasty, and external auditory canal fungal infection does not affect postoperative healing and hearing improvement. Intraoperative repeated rinsing with povidone-iodine may reduce the occurrence of postoperative infection.

EGS SO33 - Management Strategies and Outcomes of Non-Malignant Oesophageal Perforation at a Tertiary Care Hospital

Abstract Background Oesophageal perforation is a life-threatening emergency that requires prompt and effective management. This study aims to evaluate the outcomes of different management strategies—conservative, surgical, and endoscopic washout with stent insertion—for non-malignant oesophageal perforations at a specialist Upper GI unit in a tertiary care hospital. Method This is a retrospective study conducted over a 10-year period from 2012 at a specialist Upper GI Unit in a tertiary care hospital. All patients aged 18 and above who were referred to or admitted with oesophageal perforation were included, with exclusion of those with underlying oesophageal cancer. Data were collected from hospital records. Variables studied included age, gender, Charlson Comorbidity Index (CCI), WHO performance status, site and size of oesophageal perforation, treatment modality (Conservative, Surgery, or Stent), type and size of stent used, length of hospital stay, and mortality. Data analysis was performed using SPSS v.25. Results Over 10 years, 72 cases of non-malignant oesophageal perforation were managed (M:F, 37:35, median age 62.5 years (range 20-86), median CCI 3). The causes of perforation were spontaneous (n=45, 62.5%), iatrogenic (n=22,30.6%), foreign body (n=4,5.6%), and post-corrosive intake (n=1,1.4%). Most perforations occurred in the distal oesophagus (n=52, 72.2%) with an average size of perforation of 3 ± 1.38cm. Management included surgery (n=43,59.7%), conservative treatment (n=22,30.6%), and stent insertion (n=7,9.7%). Overall, in-hospital mortality was 20.8% (n=15). Survival rates varied: 90.9% for conservative treatment, 79.1% for surgical management, and 57.1% for stenting; however, the differences were not statistically significant (p=0.134). Conclusion Oesophageal perforation is a life-threatening condition. This 10-year observational study assessing conservative, surgical, and stent treatments for non-malignant perforations confirms that survival rates varied among the different treatment groups. However, there was no statistically significant survival advantage observed. This underscores the importance of developing individualized management plans based on patient factors to improve outcomes.

EGS SO27 - Removable covered stent as an alternative to traditional methods in management of Oesophageal Perforation in unfit surgical patients: A Tertiary Care Hospital Experience

Abstract Background Oesophageal perforation in elderly and frail patients carries a significantly higher mortality rate. Traditionally, management involves surgery for patients who are fit for surgery, or a conservative approach for those with minimal contamination. Endoscopy, with procedures such as endoscopic washout of mediastinal collections and placement of covered removable stents, sometimes in conjunction with chest drain insertion, is emerging as a minimally invasive option for a selected group of patients who are not suitable for traditional methods. This technique aims to seal perforations, promote healing, and facilitate early restoration of oral intake. Method This retrospective study was conducted at a tertiary care hospital. Data were collected over a 10-year period starting from 2012. The study enrolled all patients aged 18 and older, admitted with oesophageal perforation and underwent oesophageal stent insertion. SX-ELLA Danis-seal stents (30-25-30 × 135mm) were used for benign perforations, while permanent covered metal stents were used for patients with underlying malignancy. Variables analyzed included age, gender, Charlson Comorbidity Index (CCI), WHO performance status, location and size of esophageal perforation, type and dimensions of stent used, length of hospital stay, and mortality rates. Data analysis was conducted using SPSS version 25. Results During study period, 11 out of 78 patients with esophageal perforation underwent stent insertion (M:F=7:4, median age-71 (range 48-85) years, median CCI -5). Causes included spontaneous perforation (n=3,27.3%), iatrogenic (n=4,36.4%), and malignancy (n=4,36.4%). Distal esophageal perforation was observed in 7 patients (63.6%). Oral intake was commenced within 72 hours post-insertion. A single procedure sufficed for 10(90%) patients. Stents used for non-malignant perforations were removed endoscopically after an average of 12 weeks. No major complications; minor complications included stent migration (n=1, 9.1%), failed placement (n=1, 9.1%), and loss to follow-up (n=1, 9.1%). The 90-day mortality rate was 45.5% (n=5/11). Conclusion Endoscopy with mediastinal cavity washout and insertion of a covered metal stent in unfit surgical patients provides an alternative and improves outcomes. It could also be considered in patients with non-healing perforations to facilitate early resumption of oral intake.

Evaluation of Cyanoacrylate Tissue Adhesive Glue Application Outcomes in Corneal Thinning and Perforation.

Corneal thinning and perforation are ocular emergencies necessitating urgent intervention to prevent visual impairment or enucleation. Cyanoacrylate tissue adhesive is frequently used to maintain globe integrity in these cases. However, gaps remain in understanding the outcomes of corneal gluing and the factors influencing its efficacy. This case series evaluates the clinical characteristics and outcomes of glue application in corneal thinning and perforation. A retrospective chart review was conducted on patients treated for corneal thinning and perforation at the University of Florida between January 2012 and May 2023. Demographic data, clinical history, glue application details, and posttreatment outcomes were collected and analyzed. The study included 128 eyes from 125 subjects. Corneal perforation was found in 71 eyes (55.5%), mostly centrally (49.2%). The leading cause of perforation/thinning was microbial infection (45.3%). The average number of glue applications per eye was 1.66. Within 1 month, 23 patients (18.0%) required only glue reapplication, 37 (28.9%) required surgical intervention (regardless of glue reapplication), and 68 (53.1%) required no further treatment. Factors significantly linked to gluing failure (requiring surgery within 1 month) in univariate analysis included large perforation size, microbial infection, ocular surface disorder, single glue application, and indirect application via sterile drape. Multivariate analysis showed that only large perforation size was significantly associated with gluing failure. Corneal glue application is an effective temporizing measure for corneal thinning and perforation, with multiple applications potentially providing added stability to the globe. However, the need for surgical intervention is high.

Improving heat transfer in an air-cooled engine by redesigning the fins

Heat transfer modelling and simulation were carried out in a single-cylinder, four-stroke, air-cooled engine to evaluate the heat transfer rate of the engine block. The modelling studies of cylinders with different numbers of fins and different geometry were performed using the SolidWorks computer platform. The tested components were made of 6063-T6 aluminium alloy castings. The simulation concerned different numbers of fins as well as changing the geometry of fins with circular and rectangular perforations. The results of the studies showed the possibility of improving the power to mass ratio for cylinder efficiency and heat transfer rate. It was shown that a large number of fins leads to an increased heat transfer rate, but it affects the overall engine efficiency due to the increase in the total engine mass. Circular perforation is a better design solution than rectangular perforated fins with the same cross-section. Circular perforation provides a lower engine cylinder mass and gives more than 4 % better heat transfer rate. The perforation size was tested using circular perforations with a diameter of 7.14 mm, 8.5 mm and 10 mm. With a 7.14 mm diameter perforation the heat transfer rate increases slightly compared to the other tested ones, while a 10 mm diameter perforation provides the best mass reduction.

Influence of Schneiderian membrane perforation during maxillary sinus floor augmentation with lateral approach on dental implant survival rates: a retrospective study in a university setting.

The primary objective of this study was to compare implant survival rates (ISR) in patients undergoing maxillary sinus floor augmentation (MSFA) with lateral approach with and without membrane perforation. Secondary objectives were to establish the percentage of perforations in these procedures and to evaluate the influence of perforation size on ISR. This retrospective study included patients requiring MSFA with lateral approach. Cases were assigned to two groups according to the occurrence or not of perforation. The exact size of each perforation was registered. Descriptive statistics and associations between the groups were calculated. This study analyzed data from 90 MSFA in 72 patients. Membrane perforation occurred in 24.44%. A total of 170 implants were placed; 72.35% were placed under intact membranes and 27.65% on repaired membranes. The overall ISR in MSFA procedures with intact membranes was 98.37%, and 93.62% in perforated membranes. No statistically significant relationship between groups was observed although the odds of implant failure increased by 4.125 times when perforation occurred. In turn, no statistically significant relationship was observed between perforation size and ISR. Implants inserted below repaired membranes had a lower ISR compared with implants inserted below intact membranes although the difference was not statistically significant. Moreover, no significant statistical correlation was observed between perforation size and ISR. Membrane perforation does not have a significant influence on subsequent implant survival rates. Knowledge of the exact size of the membrane perforation is essential for deciding on the right treatment plan.

Correlation of Air-Bone Gap on Pure Tone Audiometry with the Size of Perforation Assessed on Oto-Endoscopy.

To determine the correlation between the air-bone gap on pure tone audiometry with size of perforation oto-endoscopically. Study Design: A descriptive study. Place and Duration of the Study: Department of ENT - Head and Neck Surgery, Dow University of Health Sciences (DUHS), from February 2020 to August 2021. Methodology: A total of 43 patients with dry central pars tensa tympanic membrane perforation were diagnosed through oto-endoscopy during the study. The mean air-bone gap was calculated by assessing each air-bone gap through pure tone audiometry at different frequencies i.e., 250 Hz, 500 Hz, 1,000 Hz, 2,000 Hz, and 4,000 Hz. Air-bone gap was found to be the average value of these frequencies. The photograph of the tympanic membrane was taken oto-endoscopically, and the ratio between size of the perforation to the entire area of the tympanic membrane was measured. During the course of the study, a total of 43 patients agreed to provide consent for this study. Out of the 43 patients, 16 (37.2%) were males and 27 (62.8%) were females. The age range was from 18 to 50 years with average age of 38.302 ± 5.74 years. The mean perforation size was 28.255 ± 9.16% while the mean air-bone gap was 28.000 ± 3.89 dB. It was concluded that the Pearson's correlation coefficient is directly correlated to perforation size and air-bone gap (r = 0.898, p <0.001). Further, hearing loss decreases with decreased middle ear volume and mastoid pneumatisation. Moreover, no change was seen in the mean air-bone gap according to the location of perforation. The hearing loss due to perforation of the tympanic membrane was correlated to the size of the perforation. Further, hearing loss decreases with reduced middle ear volume and mastoid pneumatisation. Size of perforation, Hearing loss, Air-bone gap, Oto-endoscopy, Conductive deafness, Mastoid pneumatisation.