Abstract
Objectives: To compare assessment of hearing by PTA and status of tympanic
membrane by oto-endoscope, pre-operative and post-operative tympanoplasty. Study Design:
Retrospective/ Comparative study. Setting: Social Security Landhi Hospital Karachi and Al-Tibri
medical College & Hospital, Karachi. Period: July 2017 to June 2018. Material & Methods:
76 patients were included for this study with both genders who had dry tympanic membrane
perforations. Age ranged between 18 to 40 years. Two groups were made, A (pre-operative)
and B (post-operative). In group-A, tympanic membrane perforations were examined. 45
patients had small size (25%) perforations, 15 medium size (50%) and 16 subtotal (75%).
Hearing assessment was done by Pure tone Audiometry (PTA). After 1, 2 and 3 months
post-tympanoplasty, grafted tympanic membrane was examined and pre-operated status of
tympanic membrane was compared with post-operated status of tympanic membrane. PTA
was done after 3 months and it was compared it with pre- operated PTA. Results: Examination
of tympanic membrane before tympanoplasty was performed, perforations were noted in all
patients with different sizes in their tympanic membrane. PTA (pure tone audiometry) was
advised before tympanoplasty to all patients. Weber test was performed on 1st post-operated
day, it was lateralized towards operated ear which indicate the safety of inner ear. Post-operated
1, 2 and 3 months, tympanic membrane was examined with oto-endoscope. Intact grafted
tympanic membrane was seen in 70 patients after 1 months. After 2 months, 72 patients had
intact grafted tympanic membrane and after 3 months, 73 patients out of 76 patients had intact
grafted tympanic membrane. PTA was also advised after 3 months of tympanoplasty and it was
compared with pre-operated pure tone audiometry (PTA). Air conduction (AC) was decreased
15.39dB after tympanoplasty. AB-gap reduction 13.95dB was seen in 73 patients which showed
hearing improvement. P value is < 0.001 significant. Conclusion: Tympanoplasty is a good and
safe procedure for hearing improvement by reduction of AB-gap as well as provide protection
of middle ear mucosa from infections due to closure of perforations of tympanic membranes.
Tahir Hussain Khan, Humaira Tahir, Imran Ali, Sohail Abdul Malik. (2020) Hearing assessment and status of tympanic membrane pre and post-operated tympanoplasty in cases of CSOM (Chronic Suppurative Otitis Media)., The Professional Medical Journal, Volume 27, Issue 12.
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