Publication:

Hearing assessment in patients with tympanosclerosis with intact tympanic membrane

Background Tympanosclerosis is an irreversible, though not immutable, end result of any unresolved specific or nonspecific inflammatory disease of middle ear characterized by anatomical distortion resulting in functional impairment. The objective of the study was to assess hearing in patients with tympanosclerosis with intact tympanic membrane (TM) and to correlate degree of hearing loss with respect to site of tympanosclerotic patch on TM.

Methods This cross-sectional study was conducted at Bangalore Medical College and Research Institute, Bangalore during study period from November 2016 to May 2018. Thirty patients enrolled for study were subjected to otoendoscopy, pure tone audiometry and tympanometry. Site of tympanosclerotic patch on tympanic membrane and hearing loss were assessed and correlated statistically.

Results Thirty patients (13-males, 17-females), aged 6–73 years (average-39.5 years) who fulfilled inclusion criteria were included. 7 (23.3%) patients had bilaterally affected ears amounting to 37 tympanosclerotic ears. left ear was commonly affected 14 (46.6%). In most patients, tympanosclerosis of tympanic membrane was an incidental finding with patients being otologically asymptomatic. The locations of tympanosclerotic patch on TM were 9 (24.4%) postero-superior, 7 (18.9%) postero-superior and postero-inferior, 7 (18.9%) antero-inferior, 5 (13.5%) postero-inferior, 3 (8.1%) antero-superior, 3 (8.1%) antero-superior and antero-inferior, 2 (5.4%) antero-inferior and postero-inferior and 1 (2.7%) entire pars tensa. Hearing level ranged from 10-46.6 dBHL (normal to moderate) with majority (91.89%) of patients had hearing within 25 dBHL. 43.3% had conductive hearing loss, 2.7% had sensorineural hearing loss and rest had normal hearing. Correlation of site of tympanosclerotic patch on TM with degree of hearing loss was not statistically significant (p=0.058).

Conclusions Variations in the site of tympanosclerotic patch on TM do not affect degree of hearing loss.