Correlation of Tympanic Membrane Perforation with Hearing Loss and Its Parameters in Chronic Otitis Media: An Analytical Study

  • Amit Kumar Rana
  • Deepak UpadhyayEmail author
  • Akanksha Yadav
  • Surendra Prasad
Original Article


Chronic otitis media is one of the commonest illnesses in otorhinolaryngological practice which requires medical attention. Intact tympanic membrane acts as a shield for round window niche to create a phase difference in sound wave conduction. 700 patients of age 10–70 years with inactive mucosal chronic otitis media were included in the study. Condition of tympanic membrane and site of tympanic membrane perforation was noted and audiometric analysis was performed. 338 (48.28%) were males and 362 (51.71%) were females. In 1400 membranes examined, 769 (54.85%) presented with perforation. 631 (82.03%) had unilateral perforation and 69 (17.97%) had bilateral perforations. In unilateral cases, 289 (37.50%) had right ear perforation and 342 (44.53%) left ear perforation. Single quadrant perforations were present in 168 (21.74%) membranes and 419 (54.55%) involved two quadrants. Three quadrant perforations were seen in 62 (8.09%) and 120 (15.63%) perforations involved all four quadrants. In 171 (22.26%) ears, perforation was present anterior to handle of malleus and in 243 (31.53%) it was present only posterior to handle. In 355 (46.21%) perforations, handle of malleus was involved. Perforations involving posterior half of tympanic membranes showed greater loss than those involving anterior or inferior half of membrane statistically. Maximum loss (51.56 ± 5.1 dB) was seen in perforation involving all four quadrants. In 631 unilateral cases, conductive loss was seen in 424 (67.10%), 101 (16.10%) showed sensorineural and 74 (11.80%) showed mixed loss. Out of 769 perforated ears having hearing loss, 251 (37.69%) had complaints for 5–10 years with mean loss of 51.15 ± 7.8 dB, 172 (25.68%) had COM for 1–5 years with loss of 39.26 ± 5.1 dB. A mean hearing loss of 52.18 ± 4.2 dB was seen in 110 (16.52%) patients suffering from COM for more than 10 years. 134 (20.12%) patients having disease less than 1 year reported hearing loss of 36.46 ± 8.2 dB. The effects of perforation of tympanic membranes on transmission of sound and its dynamics are not easy to correlate because of additional pathological changes in middle ear.


Perforation Position Duration Hearing loss Quadrants 



No funding was received for this project from any person or institution.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional ethical clearance committee vide letter no IEC/28/2014 and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Association of Otolaryngologists of India 2019

Authors and Affiliations

  • Amit Kumar Rana
    • 1
  • Deepak Upadhyay
    • 2
    Email author
  • Akanksha Yadav
    • 3
  • Surendra Prasad
    • 4
  1. 1.Department of Otorhinolaryngology and Head Neck SurgerySRMS Institute of Medical SciencesBareillyIndia
  2. 2.Department of Community MedicineRohilkhand Medical College and HospitalBareillyIndia
  3. 3.Department of OtorhinolaryngologyVarun Arjun Medical College and HospitalShahjahanpurIndia
  4. 4.Department of ENTNational Medical CollegeBirganjNepal

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