What factors affect the degree of hearing loss in tympanic membrane perforation (TMP)?

Updated: Dec 14, 2020
  • Author: Robert A Saadi, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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A study by Park et al indicated that perforation size and pneumatization of the middle ear and mastoid affect the degree of conductive hearing loss in cases of tympanic membrane perforation. The study involved 42 patients who underwent tympanoplasty type I, or myringoplasty, with a greater preoperative mean air-bone gap (ABG) found in association with larger perforation size and with a smaller middle ear and mastoid pneumatization volume. [17]

A prospective study by Pusz and Robitschek reported that subacutely, patients in the study who suffered a tympanic membrane perforation from a combat-related blast injury had both conductive and sensorineural hearing loss, with the latter making up 49% of the loss. [18]

The conductive hearing loss resulting from a TMP appears to be greater at lower frequencies. It increases as the perforation size grows and the volume of the middle-ear and mastoid air space decreases but does not change with location. [19, 20]

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