Introduction: Perforation of the tympanic membrane primarily results from middle ear infections, trauma or iatrogenic causes. The perforation causes conductive hearing loss by reducing the surface area available for sound transmission to the ossicular chain.

Objective: The objective was to analyze the characteristics of tympanic membrane perforations in relation to hearing loss and to determine the type and degree of hearing loss.

Materials and methods: We analyzed audiometric, otoscopic findings and medical reports of 218 patients, 114 males (52.3%) and 104 females (47.7%), aged 9 to 75 years (mean age of 47.9 years), examined during the period of November 2012 to October 2015. For statistical data analysis we used Chi-square test with level of significance p<0.05.  

Results: Most of the patients had unilateral perforations (89%) with right ear predominance and involvement of two quadrants of pars tensa (37.2%). Mean air-bone gap was 23.9 dB. The largest air-bone gap was at frequency of 250 Hz. Most of the patients (73.1%) had mixed hearing loss (p=0.032), and average hearing thresholds from 21 to 40 dB.

Conclusion: Mean air-bone gap is largest at the lower frequencies, and decreases as frequency increases. Size of the perforation has effect on hearing loss. Mean air-bone gap increases with increasing size of the perforation. There is no big difference between the mean air-bone gap in posterior versus anterior perforations.


hearing loss; perforation; tympanic membrane

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