Publication:

Role of pre-operative air-bone gap in outcome in tinnitus after undergoing type-1 tympanoplasty in patients with chronic suppurative otitis media

Background Researches suggest middle ear surgery might improve tinnitus after tympanoplasty. Purpose of this study was to investigate association between pre-operative air-bone gap (ABG) and tinnitus-outcome after tympanoplasty type I.

Methods 100 patients with tinnitus having more than 6 months of symptoms of chronic suppurative otitis media (CSOM) that were refractory to medical treatment were included in study. All patients were evaluated through otoendoscopy, pure-tone audiometry, questionnaire-based survey using the visual analogue scale (VAS) and tinnitus handicap inventory (THI) for tinnitus symptoms before and 4 months after tympanoplasty. Influence of preoperative bone conduction (BC), preoperative air-bone-gap and postoperative air-bone-gap on tinnitus outcome post-operatively was calculated.

Results Patients were divided into two groups based on preoperative BC of 25 dB. Postoperative improvement of tinnitus in both groups showed statistical significance. Patients whose preoperative air-bone-gap was 15 dB showed significant improvement in postoperative tinnitus using VAS (p<0.01) and THI (p=0.015). Postoperative change in tinnitus showed significance compared with preoperative tinnitus using VAS (p=0.006). Correlation between reduction in VAS score and air-bone-gap (p=0.201) or between reduction in THI score and air-bone-gap (p=0.270) was not significant.

Conclusions Preoperative ABG can be a predictor of tinnitus outcome after tympanoplasty in CSOM with tinnitus.