Evaluation of Hearing Improvement Following Type 1 Tympanoplasty at a Tertiary Medical Center in Bangladesh

Background: The presence of a perforation of the tympanic membrane with intermittent discharge and conductive hearing loss are the indications of Type-1 tympanoplasty.

Objective: To evaluate hearing improvement after type-1 tympanoplasty in Bangladeshi populations. Methodology: It was a two-year-long cross-sectional study conducted at the Sir Salimullah Medical College and Mitford Hospital, Dhaka from 2022 to 2024. A total of 50 patients with chronic otitis media were enrolled and observed in this study. MS Excel and SPSS were used as data analysis tools.

Results: The mean age was found 28.5 years with a range from 15 to 41 years and the male-female ratio was 1.3:1. Almost half (48.0%) of patients had medium size perforation. Preoperative hearing status according to the size of the perforation shows that hearing loss was observed in all sizes of perforation but minimum loss was found in small perforation (34.7% dB) and maximum loss in subtotal perforation (47.0 dB). In postoperative audiometry, the mean improvement of the air conduction threshold was found 12.5 dB in small, 12.8 dB in medium, 13.3dB in large, and 14.7 dB in subtotal perforation. Although improvement of hearing status was found in all sizes of perforation no significant differences were observed between different sizes of perforation. The mean air conduction threshold of all (50) patients was found 40.2 dB preoperatively and 27.1 dB postoperatively. Air-bone gap was found at 26.9 dB in the preoperative and 16.1 dB in the post-operative group. Two-thirds (66.0 %) of patients improved <15 dB air conduction threshold and 17 (34.0%) improved ≥15 dB air conduction threshold.

Conclusion: Size & site of perforation affects the degree of hearing loss. Significant improvement of air conduction threshold and AB gap observed after type-1 tympanoplasty. Thus, from this study, it can be concluded that type-1 tympanoplasty is an effective technique for hearing improvement in inactive mucous type of chronic otitis media.

Keywords: Inactive Mucous Type Of Chronic Otitis Media, Type-1 Tympanoplasty, Hearing Improvement.