Evaluation of Hearing Loss in Tympanic Membrane Perforation

  • Kulwant Kaur Pannu
  • Snya Chadha
  • Dinesh Kumar
  • Preeti
Original Article


To evaluate and analyse the hearing loss in tympanic membrane perforation based on size, site and duration of perforation. The material for this study was comprised of 100 patients of either sex and of age 15 years and above selected randomly. Size of tympanic membrane perforation was assessed under microscope using calibrated wire look. Patients were divided into three groups according to size; group I (0–9 mm2), Group II (9–30 mm2), Group III (≥ 30 mm2); according to site into anterior and posterior group; according to involvement of malleus into malleolar and non malleolar and according to duration into Group A (<1 year), Group B (1–5 years), Group C (≥ 5 years). Hearing loss was measured in each case with pure tone audiometry. Data was analysed statistically using paired t-test. Hearing loss increased as the perforation size increased [I vs. II (t − 4.23, p < 0.001), II vs. III (t − 8.19, p < 0.001), I vs. III (t − 11.68, p < 0.001)]. Hearing loss was more in posterior quadrant perforation than anterior quadrant perforation but difference was not significant statistically (t − 1.15, p > 0.05). Hearing loss was more in malleolar perforation (t − 5.74, p < 0.001). Hearing loss increased as the duration of disease increased [A vs. B (t − 2.01, p < 0.043), A vs. C (t − 5.49, p < 0.001), B vs. C (t − 4.14, p < 0.001)].


Hearing loss Perforation Tympanic membrane 



The paper was read at National Conference AOI&HNS at Jaipur Jan 2009.


  1. 1.
    Donaldson JA, Duckert LG (1991) Anatomy of the ear. In: Paparella MM, Shumrick DA (eds) Otolaryngology. Basic sciences and related principles, 3rd edn. WB Saunders Company, Philadelphia, p 26Google Scholar
  2. 2.
    Wever EG, Lawrence M (1954) Physiological acoustics. Princeton University Press, Princeton, NJ; Cited by Dahmann H (1991) Physiology of the middle ear and eustachian tube. In: Paparella MM, Shumrick DA (eds) Otolaryngology. Basic sciences and related principles, 3rd edn. W.B. Saunders Company, Philadelphia, pp 188–189Google Scholar
  3. 3.
    Caye Thomasen P, Torfinnur RN, Mirko T (2007) Bilateral myringoplasty in chronic otitis media. Laryngoscope 117:903–906Google Scholar
  4. 4.
    Kurian CA (1996) Homologous dura for myringoplasty. Indian J Otolaryngol Head Neck Surg 48(2):150–152Google Scholar
  5. 5.
    Ramanuj B, Anoop R (1998) Hearing loss in rural population. The etiology. Indian J Otolaryngol Head Neck Surg 50(2):147–154CrossRefGoogle Scholar
  6. 6.
    Hemant C, Vanita C (2001) Technique of anterior bucking of graft in tympanoplasty. Indian J Otology 7(4):167–170Google Scholar
  7. 7.
    Gulati SP, Sachdeva OP, Kumar P (2002) Audiological profile in CSOM. Indian J Otolaryngol 8:24–28Google Scholar
  8. 8.
    Chandra S, Sinha V, Kranti B, Kumar R, Roy M, Mishra SK (2006) Myrinocautery: our experience. Indian J Otolaryngol 12:28–30Google Scholar
  9. 9.
    Ahmad SW, Ramani GV (1979) Hearing loss in perforation of tympanic membrane. J Laryngol Otol 93:1091–1098PubMedCrossRefGoogle Scholar
  10. 10.
    Voss SE, Rosowski JJ, Merchant SN, Peake WT (2001) How do tympanic membrane perforations affect middle ear sound transmission. Acta Otolaryngol 121(2):169–173PubMedCrossRefGoogle Scholar
  11. 11.
    Shambaugh (2003) Surgery of the ear, 5th edn. BC Decker, Hamilton, pp 71–73Google Scholar
  12. 12.
    Mehta RP, Rosowski JJ, Voss SE, Neil OE, Merchant SN (2006) Determinants of hearing loss in perforations of the tympanic membrane. Otol Neurotol 27:136PubMedCrossRefGoogle Scholar
  13. 13.
    Shah S, Bhat V, Gupta D, Sinha V (2006) A study of correlation of site and size of perforation with deafness. Indian J Otology 12:47–49Google Scholar

Copyright information

© Association of Otolaryngologists of India 2011

Authors and Affiliations

  • Kulwant Kaur Pannu
    • 1
    • 2
  • Snya Chadha
    • 1
  • Dinesh Kumar
    • 1
  • Preeti
    • 1
  1. 1.Department of E.N.TGovt. Medical CollegeAmritsarIndia
  2. 2.C/o Pannu Eye HospitalAmritsarIndia

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