A CLINICAL STUDY ON HOW THE SIZE AND LOCATION OF TYMPANIC MEMBRANE PERFORATIONS AFFECT HEARING LOSS

Background: Tympanic membrane perforations are common causes of conductive hearing loss. Both the size and location of the perforation are thought to influence the degree of hearing impairment, but the relationship remains incompletely understood. Objective: To evaluate how the size and location of tympanic membrane perforations affect the severity of hearing loss. Methods: A clinical study was conducted involving patients with tympanic membrane perforations. Perforations were classified by size (small, medium, large) and location (anterior, posterior). Pure tone audiometry was used to measure hearing thresholds and air-bone gaps. Statistical analysis assessed the correlation between perforation characteristics and hearing loss. Results: Mean hearing loss on PTA increased with perforation size: 30.49±3.90 dB for small (1–15 mm²), 37.56±3.02 dB for medium (15–27 mm²), and 46.51±7.32 dB for large (28–41 mm²) perforations. Hearing loss was significantly proportional to perforation size (p<0.05). Posterior perforations demonstrated a higher degree of hearing impairment compared to anterior perforations (36.29±5.31dB and 33.74±5.47dB respectively). The findings highlight the impact of perforation attributes on middle ear sound conduction. Conclusion: Both size and location of tympanic membrane perforations play a critical role in the extent of conductive hearing loss. These insights can guide clinical evaluation and management of patients with tympanic membrane perforations.