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Published in: BMC Ear, Nose and Throat Disorders 1/2009

Open Access 01-12-2009 | Research article

Correlating the site of tympanic membrane perforation with Hearing loss

Authors: Titus S Ibekwe, Onyekwere G Nwaorgu, Taiwo G Ijaduola

Published in: BMC Ear, Nose and Throat Disorders | Issue 1/2009

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Abstract

Background

It 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.

Methods

A 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.

Results

Sixty-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).

Conclusion

The 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.
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Literature
1.
go back to reference Ogisi FO, Adobamen P: Type 1 Tympanoplasty in Benin: A 10-year review. The Nigerian Postgraduate Medical Journal. 2004, 11: 84-87.PubMed Ogisi FO, Adobamen P: Type 1 Tympanoplasty in Benin: A 10-year review. The Nigerian Postgraduate Medical Journal. 2004, 11: 84-87.PubMed
2.
go back to reference Voss SE, Rosowski JJ, Merchant SN, Peake WT: Non-ossicular signal transmission in human middle ears: Experimental assessment of the "acoustic route" with perforated tympanic membranes. J Acoust Soc Am. 2007, 122: 2135-2153. 10.1121/1.2769617.CrossRefPubMedPubMedCentral Voss SE, Rosowski JJ, Merchant SN, Peake WT: Non-ossicular signal transmission in human middle ears: Experimental assessment of the "acoustic route" with perforated tympanic membranes. J Acoust Soc Am. 2007, 122: 2135-2153. 10.1121/1.2769617.CrossRefPubMedPubMedCentral
3.
go back to reference Shamb Baugh GE: From Surgery of the ear. 1959, Philadelphia WB Saunder, 336-7. Shamb Baugh GE: From Surgery of the ear. 1959, Philadelphia WB Saunder, 336-7.
4.
go back to reference Krunger , Tonndorf : Tympanic-membrane perforation in cats with experimentally induced Tympanic-membrane perforation. J Acoust Soc Am. 1978, 63: 436-441. 10.1121/1.381735.CrossRef Krunger , Tonndorf : Tympanic-membrane perforation in cats with experimentally induced Tympanic-membrane perforation. J Acoust Soc Am. 1978, 63: 436-441. 10.1121/1.381735.CrossRef
6.
go back to reference Ahmad SW, Ramani GV: Hearing loss in tympanic membrane perforations. JLO. 1979, 93: 1091-1098. 10.1017/S0022215100088162.CrossRef Ahmad SW, Ramani GV: Hearing loss in tympanic membrane perforations. JLO. 1979, 93: 1091-1098. 10.1017/S0022215100088162.CrossRef
7.
go back to reference Roland NJ, McRae RDR, McCombe AW: From Chronic suppurative otitis media. Key topics in Otolaryngology and head and neck surgery. 2001, Wales, Bios scientific publishers, 38-41. 2 Roland NJ, McRae RDR, McCombe AW: From Chronic suppurative otitis media. Key topics in Otolaryngology and head and neck surgery. 2001, Wales, Bios scientific publishers, 38-41. 2
9.
go back to reference Voss SE, Rosowski JJ, Merchant SN, et al: Middle ear pathology can affect the ear canal sound pressure generated by audiologic earphones. Ear & hearing. 2000, 21: 265-274. 10.1097/00003446-200008000-00001.CrossRef Voss SE, Rosowski JJ, Merchant SN, et al: Middle ear pathology can affect the ear canal sound pressure generated by audiologic earphones. Ear & hearing. 2000, 21: 265-274. 10.1097/00003446-200008000-00001.CrossRef
10.
go back to reference Ibekwe TS, Ijaduola GT, Nwaorgu OG: Tympanic membrane perforation among adults in West Africa. Otol Neurotol. 2007, 28: 348-52. 10.1097/MAO.0b013e3180311605.CrossRefPubMed Ibekwe TS, Ijaduola GT, Nwaorgu OG: Tympanic membrane perforation among adults in West Africa. Otol Neurotol. 2007, 28: 348-52. 10.1097/MAO.0b013e3180311605.CrossRefPubMed
11.
go back to reference Hsu CY, Chen JH, Hwang , et al: A computer programme to calculate the size of tympanic-membrane perforation. Clinical Otolaryngology. 2004, 29: 340-342. 10.1111/j.1365-2273.2004.00838.x.CrossRefPubMed Hsu CY, Chen JH, Hwang , et al: A computer programme to calculate the size of tympanic-membrane perforation. Clinical Otolaryngology. 2004, 29: 340-342. 10.1111/j.1365-2273.2004.00838.x.CrossRefPubMed
12.
go back to reference Voss SE, Rosowski JJ, Merchant SN, et al: Acoustic responses of human middle ear. Hearing Research. 2000, 150: 43-69. 10.1016/S0378-5955(00)00177-5.CrossRefPubMed Voss SE, Rosowski JJ, Merchant SN, et al: Acoustic responses of human middle ear. Hearing Research. 2000, 150: 43-69. 10.1016/S0378-5955(00)00177-5.CrossRefPubMed
13.
go back to reference Oktay MF, Cureoglu S, Schachern PA, et al: Tympanic membrane changes in central tympanic membrane perforations. Am J Otolarngol. 2005, 26: 393-397. 10.1016/j.amjoto.2005.05.005.CrossRef Oktay MF, Cureoglu S, Schachern PA, et al: Tympanic membrane changes in central tympanic membrane perforations. Am J Otolarngol. 2005, 26: 393-397. 10.1016/j.amjoto.2005.05.005.CrossRef
14.
go back to reference Fukuchi I, Cerchiari DP, Garcia E, et al: Tympanoplasty: surgical results and a comparison of the factors that may interfere in their success. Braz J Otorhinolaryngol. 2006, 72 (2): 267-271.CrossRefPubMed Fukuchi I, Cerchiari DP, Garcia E, et al: Tympanoplasty: surgical results and a comparison of the factors that may interfere in their success. Braz J Otorhinolaryngol. 2006, 72 (2): 267-271.CrossRefPubMed
15.
go back to reference Bekesy GV: Weber die mechanisch-akustischen Vorangusy beim Horen. Acta Otolaryngology. 1939, 27: 281-296. 10.3109/00016483909124145. 388–396, (abstr).CrossRef Bekesy GV: Weber die mechanisch-akustischen Vorangusy beim Horen. Acta Otolaryngology. 1939, 27: 281-296. 10.3109/00016483909124145. 388–396, (abstr).CrossRef
16.
go back to reference Payne MC, Gither FJ: Effects of perforation of TM on cochlear potentials. Archives of Otolaryngology. 1951, 54: 666-674.CrossRefPubMed Payne MC, Gither FJ: Effects of perforation of TM on cochlear potentials. Archives of Otolaryngology. 1951, 54: 666-674.CrossRefPubMed
17.
go back to reference Gan RZ, Reeves BP, Wang X: Modeling of sound transmission from ear canal to cochlea. Ann Biomed Eng. 2007, 35: 2180-2195. 10.1007/s10439-007-9366-y.CrossRefPubMed Gan RZ, Reeves BP, Wang X: Modeling of sound transmission from ear canal to cochlea. Ann Biomed Eng. 2007, 35: 2180-2195. 10.1007/s10439-007-9366-y.CrossRefPubMed
18.
go back to reference Voss SE, Rosowski JJ, Merchant SN, et al: Middle-ear function with tympanic-membrane perforations. II. A simple model. J Acoust Soc Am. 2001, 110: 1445-1452. 10.1121/1.1394196.CrossRefPubMed Voss SE, Rosowski JJ, Merchant SN, et al: Middle-ear function with tympanic-membrane perforations. II. A simple model. J Acoust Soc Am. 2001, 110: 1445-1452. 10.1121/1.1394196.CrossRefPubMed
19.
go back to reference Gan RZ, Sun O, Feng B, Wood MW: Acoustic-structural coupled finite element analysis for sound transmission in human ear-pressure distributions. Med Eng Phys. 2006, 28: 395-404. 10.1016/j.medengphy.2005.07.018.CrossRefPubMed Gan RZ, Sun O, Feng B, Wood MW: Acoustic-structural coupled finite element analysis for sound transmission in human ear-pressure distributions. Med Eng Phys. 2006, 28: 395-404. 10.1016/j.medengphy.2005.07.018.CrossRefPubMed
20.
go back to reference Mehta RP, Rosowski JJ, Voss SE, et al: Determinants of hearing loss in perforations of the tympanic membrane. Otol Neurotol. 2006, 27: 136-143. 10.1097/01.mao.0000176177.17636.53.CrossRefPubMedPubMedCentral Mehta RP, Rosowski JJ, Voss SE, et al: Determinants of hearing loss in perforations of the tympanic membrane. Otol Neurotol. 2006, 27: 136-143. 10.1097/01.mao.0000176177.17636.53.CrossRefPubMedPubMedCentral
Metadata
Title
Correlating the site of tympanic membrane perforation with Hearing loss
Authors
Titus S Ibekwe
Onyekwere G Nwaorgu
Taiwo G Ijaduola
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Ear, Nose and Throat Disorders / Issue 1/2009
Electronic ISSN: 1472-6815
DOI
https://doi.org/10.1186/1472-6815-9-1

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