Abstract：
BACKGROUND: Tympanic membrane perforation due to inactive mucosal chronic suppurative otitis media is a common problem in otolaryngology, with consequent conductive hearing loss. Still, there is controversy about the relationship between the location of the tympanic membrane perforation and the degree of hearing impairment.
OBJECTIVE: To assess the correlation between the location of a small tympanic membrane perforation and the degree of conductive hearing loss in adult patients with inactive mucosal chronic suppurative otitis media.
METHODS: A prospective cross-sectional study enrolled 74 adult patients with small tympanic membrane perforations (perforation involves less than one quadrant of the tympanic membrane) and conductive hearing loss (airbone gap ≥ 20 dB HL) due to inactive mucosal chronic suppurative otitis media for at least 3 months. The locations of the tympanic membrane perforations were classified as anterosuperior, anteroinferior, posterosuperior, and poster inferior perforations. Audiometric analysis and a CT scan of the temporal bone were done for all patients. The means of the air and bone conduction pure tone hearing threshold averages at frequencies 500, 1000, 2000, and 4000 Hz were calculated, and consequently, the air-bone gaps were calculated and presented as means. The ANOVA test was used to compare the means of the air-bone gaps, and the Scheffe test was used to determine if there were statistically significant differences regarding the degree of conductive hearing loss in relation to different locations of the tympanic membrane perforation.
RESULTS: The ages of the patients ranged from 20 to 43 years (mean = 31.9 ± 6.5 years), of whom 43 (58%) were females and 31 (42%) were males. The means of the air-bone gaps were 32.29 ± 5.41 dB HL, 31.34 ± 4.12 dB HL, 29.87 ± 3.48 dB HL, and 29.30 ± 4.60 dB HL in the posteroinferior, posterosuperior, anteroinferior, and anterosuperior perforations, respectively. Although the air-bone gap\'s mean was greater in the posteroinferior perforation, statistical analysis showed that it was insignificant (P-value=0.168).
CONCLUSIONS: In adult patients with inactive chronic suppurative otitis media, the anteroinferior quadrant is the most common location of the tympanic membrane perforation, and there was an insignificant correlation between the location of a small tympanic membrane perforation and the degree of conductive hearing loss.
OBJECTIVE: To assess the correlation between the location of a small tympanic membrane perforation and the degree of conductive hearing loss in adult patients with inactive mucosal chronic suppurative otitis media.
METHODS: A prospective cross-sectional study enrolled 74 adult patients with small tympanic membrane perforations (perforation involves less than one quadrant of the tympanic membrane) and conductive hearing loss (airbone gap ≥ 20 dB HL) due to inactive mucosal chronic suppurative otitis media for at least 3 months. The locations of the tympanic membrane perforations were classified as anterosuperior, anteroinferior, posterosuperior, and poster inferior perforations. Audiometric analysis and a CT scan of the temporal bone were done for all patients. The means of the air and bone conduction pure tone hearing threshold averages at frequencies 500, 1000, 2000, and 4000 Hz were calculated, and consequently, the air-bone gaps were calculated and presented as means. The ANOVA test was used to compare the means of the air-bone gaps, and the Scheffe test was used to determine if there were statistically significant differences regarding the degree of conductive hearing loss in relation to different locations of the tympanic membrane perforation.
RESULTS: The ages of the patients ranged from 20 to 43 years (mean = 31.9 ± 6.5 years), of whom 43 (58%) were females and 31 (42%) were males. The means of the air-bone gaps were 32.29 ± 5.41 dB HL, 31.34 ± 4.12 dB HL, 29.87 ± 3.48 dB HL, and 29.30 ± 4.60 dB HL in the posteroinferior, posterosuperior, anteroinferior, and anterosuperior perforations, respectively. Although the air-bone gap\'s mean was greater in the posteroinferior perforation, statistical analysis showed that it was insignificant (P-value=0.168).
CONCLUSIONS: In adult patients with inactive chronic suppurative otitis media, the anteroinferior quadrant is the most common location of the tympanic membrane perforation, and there was an insignificant correlation between the location of a small tympanic membrane perforation and the degree of conductive hearing loss.
摘要：
背景：非活动性粘膜慢性化脓性中耳炎引起的鼓膜穿孔是耳鼻喉科的常见问题，随之而来的传导性听力损失。尽管如此，关于鼓膜穿孔的位置与听力损伤程度之间的关系存在争议。
目的：评估成年非活动性粘膜慢性化脓性中耳炎患者的小鼓膜穿孔位置与传导性听力损失程度之间的相关性。
方法：一项前瞻性横断面研究纳入了74名成年患者，这些患者因至少3个月的非活动性慢性化脓性中耳炎而出现小鼓膜穿孔（穿孔累及鼓膜不到一个象限）和传导性听力损失（气骨间隙≥20dBHL）。鼓膜穿孔的位置被分类为前上，前下，后上级，和海报下穿孔。对所有患者进行了听力分析和颞骨CT扫描。计算了频率为500、1000、2000和4000Hz的空气和骨传导纯音听阈平均值，因此，计算了气-骨间隙,并将其表示为平均值.方差分析测试用于比较空气-骨骼间隙的平均值，Scheffe检验用于确定鼓膜穿孔不同位置的传导性听力损失程度是否存在统计学上的显著差异。
结果：患者的年龄范围为20至43岁（平均=31.9±6.5岁），其中女性43人（58%），男性31人（42%）。空气-骨骼间隙的平均值为32.29±5.41dBHL，31.34±4.12dBHL,29.87±3.48dBHL，和29.30±4.60dB后下段HL，后上级，前下，和前上穿孔，分别。尽管在后下穿孔中空气-骨间隙的平均值更大，统计学分析显示无统计学意义(P值=0.168)。
结论：在患有非活动性慢性化脓性中耳炎的成年患者中，前下象限是鼓膜穿孔最常见的位置，小鼓膜穿孔的位置与传导性听力损失的程度之间的相关性不明显。
目的：评估成年非活动性粘膜慢性化脓性中耳炎患者的小鼓膜穿孔位置与传导性听力损失程度之间的相关性。
方法：一项前瞻性横断面研究纳入了74名成年患者，这些患者因至少3个月的非活动性慢性化脓性中耳炎而出现小鼓膜穿孔（穿孔累及鼓膜不到一个象限）和传导性听力损失（气骨间隙≥20dBHL）。鼓膜穿孔的位置被分类为前上，前下，后上级，和海报下穿孔。对所有患者进行了听力分析和颞骨CT扫描。计算了频率为500、1000、2000和4000Hz的空气和骨传导纯音听阈平均值，因此，计算了气-骨间隙,并将其表示为平均值.方差分析测试用于比较空气-骨骼间隙的平均值，Scheffe检验用于确定鼓膜穿孔不同位置的传导性听力损失程度是否存在统计学上的显著差异。
结果：患者的年龄范围为20至43岁（平均=31.9±6.5岁），其中女性43人（58%），男性31人（42%）。空气-骨骼间隙的平均值为32.29±5.41dBHL，31.34±4.12dBHL,29.87±3.48dBHL，和29.30±4.60dB后下段HL，后上级，前下，和前上穿孔，分别。尽管在后下穿孔中空气-骨间隙的平均值更大，统计学分析显示无统计学意义(P值=0.168)。
结论：在患有非活动性慢性化脓性中耳炎的成年患者中，前下象限是鼓膜穿孔最常见的位置，小鼓膜穿孔的位置与传导性听力损失的程度之间的相关性不明显。
