RELATIONSHIP OF HEARING LOSS AND SITE OF TYMPANIC MEMBRANE PERFORATION IN CHRONIC SUPPURATIVE OTITIS MEIDA PATIENTS

Abstract

Objectives
Chronic suppurative otitis media (CSOM) is a common cause of tympanic membrane perforation and conductive hearing loss, particularly in developing countries. This study aimed to determine the relationship between the site of tympanic membrane perforation and the degree of hearing loss in patients diagnosed with CSOM.

Methodology
A hospital-based cross-sectional study was conducted in the Department of ENT of a tertiary care hospital, in Rawalpindi. A total of 100 patients clinically diagnosed with CSOM were enrolled after obtaining informed consent and ethical approval. Patients with a history of ear trauma, previous ear surgery, otosclerosis, congenital ear anomalies, or systemic causes of hearing loss were excluded. Detailed clinical history and otoscopic examination were performed to identify and categorize the site of tympanic membrane perforation as anterior, posterior, central, subtotal, or total. Pure tone audiometry was conducted to assess hearing thresholds, and the degree of hearing loss was classified according to standard criteria. Data were analyzed using descriptive statistics, Chi-square test, and one-way ANOVA, with p < 0.05 considered statistically significant.

Results
The mean age of participants was 32.4 ± 11.6 years, with a male predominance (58%). Central perforation (34%) was the most common type, while total perforation (10%) was the least frequent. Hearing loss ranged from mild to severe, with moderate loss being most common. A statistically significant association was found between the site of perforation and the degree of hearing loss (p < 0.05). Larger and posteriorly located perforations were associated with higher mean hearing thresholds, with total perforations showing the greatest impairment (54.8 ± 12.6 dB).

Conclusion
There is a significant relationship between the site of tympanic membrane perforation and the severity of hearing loss in CSOM. Both the size and anatomical location of perforation influence the degree of conductive hearing impairment.