Study of the relationship between the size, location, and duration of tympanic membrane perforation with the value of Air-Bone Gap on pure-tone audiogram

Abstract

Abstract Background Tympanic membrane perforation can lead to hearing loss, infection, and negatively affect daily activities. Therefore, it is important to study this condition, and to further understand its causes and symptoms. We conducted this study in which we aim to evaluate the effect of the size, location, and duration of tympanic membrane perforation on the value of the air-bone gap. Methods a cross-sectional study in Damascus hospital, on cases from 2014 to 2023, including 83 cases of either sex, 22 cases were bilateral, so the total number of perforation cases was 105, aged 13 years and above, unilateral and bilateral, randomly selected. Results Our study included 83 cases, their ages ranged from [13–70] years, with an average of 31.84 ± 12.97. Of the 83 patients, 36 (43.4%) were male and 47 (56.6%) were female. Most cases of perforation were unilateral 61 (73.5%), with a preponderance of left-sided perforation 54 (51.4%). Inflammatory perforation was the most common 62 (59%). Duration of perforation was the most common (less than a year), with a rate of 22 (16.4%). For the size and location of the perforation, the largest percentage (for a central medium) was 26 (24.8%). Hearing loss was 86 (81.9%) as the most common symptom related to the perforation side, and vertigo 9 (10.8%) as the most common symptom not related to the perforation side. By studying the size and location of the perforation, we found that an increase in the size of the tympanic membrane perforation is associated with an increase in the value of the air-bone gap, and by comparing the posterior-inferior-central perforation with the anterior-inferior-central perforations, we found that the posterior-inferior-central perforations are associated with a greater value of the air-bone gap. We also found that as the duration of perforation increases, the value of the air-bone gap increases.