The correlation between hearing loss and the site of eardrum perforation: about 260 cases

Introduction: Some authors have assumed that the hearing loss depends on the site and the size of the perforations, but the results were contradictory and inconclusive. The aim of this present study is to find correlation between hearing loss and the location of tympanic membrane perforation after a chronic otitis media. Materials and Methods: A retrospective study was conducted in our ENT department, university hospital Ibn Rochd Casablanca Morocco. Two hundred sixty patients were enrolled in this study with eardrum perforation and without any neurosensory hearing loss or middle/ inner ear diseases. Data processing and analysis were carried out with computer software SPSS. Results: Two hundred sixty patients (103 males, 157 females) with age range 8–67 years (mean = 35.9) were studied. Bilateral tympanic membrane perforations were seen in 84 patients (60%), unilateral perforation in 176 patients (68%). In the 260 patients, 253 eardrum perforations were caused by chronic otitis media. Only 7 cases were due to a traumatism. The tympanic perforation was posterior in 64 cases (24.6%), subtotal in 54 cases (20.8%), central in 49 cases (18.8%), anterior in 44 cases (16.9%), antero-superior in 1 case, antero-inferior in 23 cases (8.8%), postero-superior in 5 cases (1.9%), and postero-inferior in 10 cases (3.8%). The tympanic perforation was inferior in 10 cases (3.8%). Perforation’s sites on the tympanic membrane were correlated with the groups of average hearing loss. For anterior perforations the average loss was moderate in 52.3% and severe in 13.6%. For posterior perforations the average loss was moderate in 75%. For subtotal perforation, the percentage was equal for mild and moderate hearing loss. The average loss for anterior perforations was 41.93 dB. The average loss for posterior ones was 42.66 dB. Conclusion: The current study aimed to correlate the degree of hearing loss to the different site of perforation. From the present study we can tell that Hearing loss in chronic otitis media is independent of the site of eardrum perforation. Nevertheless, further studies are needed with a representative population to confirm our results. Keywords: Site of eardrum perforation; Hearing loss; Bone conductio