The Effect of Tympanic Membrane Perforation Site, Size and Middle Ear Volume on Hearing Loss

Özet

Objective: The aim of this study was to analyze thelocation and the size of perforation in cases with tympanic membrane perforation, its relation to the manubrium mallei and middle ear volume, and to investigate how these are correlated with the severity andfrequencies of conductive hearing loss.Methods: This prospectively designed study includedthe patients who presented to the the Department ofOtorhinolaryngology at the Dokuz Eylül Universitywith hearing loss or tinnitus complaints in the periodfrom June 2014 through June 2017 and were identified to have tympanic membrane perforation in theirotoscopic examination. Patients who underwent myringoplasty and type 1 tympanoplasty and whose airbone gap was found lower than 10 dB in the postoperative audiological examination were included in thestudy. Effects of the perforation size, the perforationsite, and the relationship of the perforation with themanubrium, as well as the effects of the middle earvolume on the severity and frequency of conductivehearing loss were compared.Results: The study included 44 ears of 38 patients(13 male and 25 female) of whom six had tympanicmembrane perforation in both ears. Air conductionthreshold and air-bone gap were significantly foundhigher if the perforation area was wide (p<0.05), theperforation involved both the anterior and the posterior quadrants (p<0.05), had contact with the manubrium mallei (p<0.05), and the middle ear volumereduced (p<0.05).Conclusion: Solely tympanic membrane perforationaffects hearing function; nevertheless, hearing function are better in cases, which have perforations smallin size, no contact with manubrium mallei and wellpneumatized middle ears.