ORIGINAL ARTICLE
HEARING LOSS IN CHILDREN AFTER TYMPANIC MEMBRANE PERFORATION: CLUSTER ANALYSIS OF 27 CASES
 
More details
Hide details
1
Department of Paediatric Otolaryngology, Phoniatrics and Audiology of Medical University of Lublin, Medical University of Lublin, Poland
 
 
A - Research concept and design; B - Collection and/or assembly of data; C - Data analysis and interpretation; D - Writing the article; E - Critical revision of the article; F - Final approval of article;
 
 
Submission date: 2021-12-26
 
 
Final revision date: 2022-09-11
 
 
Acceptance date: 2022-11-23
 
 
Online publication date: 2022-12-29
 
 
Publication date: 2022-12-29
 
 
Corresponding author
Joanna Jabłońska   

Department of Paediatric Otolaryngology, Phoniatrics and Audiology of Medical University of Lublin, Medical University of Lublin, Gebali 6, 20-093, Lublin, Poland
 
 
J Hear Sci 2022;12(4):39-46
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Tympanic membrane perforation (TMP) may be caused by several factors but commonly leads to conductive hearing loss. This study aims to characterize the profiles of hearing loss in pediatric patients with TMPs.

Material and methods:
A retrospective analysis of the medical charts of 27 patients was conducted. Otoscopy of the TM was done and pure tone audiometry was used to assess hearing loss. Cluster analysis was applied to evaluate the profiles of hearing loss and to find possible relations between profiles of hearing loss and the location of the perforation on the TM.

Results:
Cluster analysis revealed three types of hearing loss. The mean hearing loss in cluster 1 (6 cases) was above 30 dB, mainly as the result of perforation after chronic otitis media. Hearing loss in clusters 2 (9 cases) and 3 (12 cases) was less than 30 dB. In cluster 2 the perforation was mostly located in the posterior quadrants, while in cluster 3 it was most commonly in the inferior quadrants. In clusters 2 and 3, perforation was usually caused by slap of the open hand, injury, or past ventilation tube.

Conclusions:
Three different profiles (clusters) of hearing loss resulting from TMP were identified. Force of injury, etiology of the injury, and inflammation produce different sizes of perforations. Conductive hearing loss increases with perforation size and is independent of TM location. In general, hearing loss classification methods have the potential to improve diagnostic procedures, surgery, and rehabilitation of patients with TMPs.

 
REFERENCES (27)
1.
Cai L, Stomackin G, Perez NM, Lin X, Jung TT, Dong W. Recovery from tympanic membrane perforation: effects on membrane thickness, auditory thresholds, and middle ear transmission. Hear Res, 2019; 384: 107813.
 
2.
Cheng JT, Hamade M, Merchant SN, Rosowski JJ, Harrington E, Furlong C. Wave motion on the surface of the human tympanic membrane: holographic measurement and modeling analysis. J Acoust Soc Am, 2013; 133(2): 918–37.
 
3.
Lou ZC, Lou ZH, Zhang QP. Traumatic tympanic membrane perforations: a study of etiology and factors affecting outcome. Am J Otolaryngol, 2012; 33(5): 549–55.
 
4.
Cayir S, Mutlu H. Traumatic tympanic membrane perforation in children in the emergency department: comparison of spontaneous closure and paper patch. Cureus, 2020; 12(4): e7697.
 
5.
Carniol ET, Bresler A, Shaigany K, Svider P, Baredes S, Eloy JA, et al. Traumatic tympanic membrane perforations diagnosed in emergency departments. JAMA Otolaryngol Neck Surg, 2018; 144(2): 136–9.
 
6.
Mehta RP, Rosowski JJ, Voss SE, O’Neil E, Merchant SN. Determinants of hearing loss in perforations of the tympanic membrane: Otol Neurotol, 2006; 27(2): 136–43.
 
7.
Olusanya, BO, Davis, AC, Hoffman, HJ. Hearing loss grades and the international classification of functioning, disability and health. Bulletin of the World Health Organization, 2019; 97(10): 725–8.
 
8.
Rozendorn N, Wolf M, Yakirevich A, Shapira Y, Carmel E. Myringoplasty in children. Int J Pediatr Otorhinolaryngol, 2016; 90: 245–50.
 
9.
Silveira Netto LF, da Costa SS, Sleifer P, Braga MEL. The impact of chronic suppurative otitis media on children’s and teenagers’ hearing. Int J Pediatr Otorhinolaryngol, 2009; 73(12): 1751–6.
 
10.
Lieu JEC, Kenna M, Anne S, Davidson L. Hearing loss in children: a review. JAMA, 2020; 324(21): 2195–205.
 
11.
Axelsson A, Jerson T, Lindberg U, Lindgren F. Early noise-induced hearing loss in teenage boys. Scand Audiol, 1981; 10(2): 91–6.
 
12.
Moore BC. A review of the perceptual effects of hearing loss for frequencies above 3 kHz. Int J Audiol, 2016; 55(12): 707–14.
 
13.
Cox H, Ford G. Hearing loss associated with weapons noise exposure: when to investigate an asymmetrical loss. J Laryngol Otol, 1995; 109(4): 291–5.
 
14.
Kashyap R. Significance of 6 kHz in noise induced hearing loss in Indian Air Force personnel. Indian J Aerosp Med, 2008; 52(2): 15–20.
 
15.
Niskar AS, Kieszak SM, Holmes A, Esteban E, Rubin C, Brody DJ. Prevalence of hearing loss among children 6 to 19 years of age: the Third National Health and Nutrition Examination Survey. JAMA, 1998; 279(14): 1071–5.
 
16.
Rousseeuw, PJ. Silhouettes: a graphical aid to the interpretation and validation of cluster analysis. J Comp Appl Math, 1987; 20: 53-65.
 
17.
Caliński T, Harabasz J. A dendrite method for cluster analysis. Comm Stat Th Methods, 1974; 3(1): 1–27.
 
18.
Ward JH. Hierarchical grouping to optimize an objective function. J Am Stat Assoc, 1963; 58(301): 236–44.
 
19.
Hartigan JA, Wong MA. Algorithm AS 136: A k-means clustering algorithm. J Roy Stat Soc Series C, 1979; 28(1): 100–8.
 
20.
Krzanowski WJ, Lai, YT. A criterion for determining the number of groups in a data set using sum-of-squares clustering. Biometrics, 1988; 44(1): 23–34.
 
21.
Rana AK, Upadhyay D, Yadav A, Prasad S. Correlation of tympanic membrane perforation with hearing loss and its parameters in chronic otitis media: an analytical study. Indian J Otolaryngol Head Neck Surg, 2020; 72(2): 187–93.
 
22.
Voss SE, Rosowski JJ, Merchant SN, Peake WT. How do tympanic-membrane perforations affect human middle-ear sound transmission? Acta Otolaryngol (Stockh), 2001; 121(2): 169–73.
 
23.
Lerut B, Pfammatter A, Moons J, Linder T. Functional correlations of tympanic membrane perforation size. Otol Neurotol, 2012; 33(3): 379–86.
 
24.
Castelhano L, Correia F, Colaço T, Reis L, Escada P. Tympanic membrane perforations: the importance of etiology, size and location. Eur Arch Otorhinolaryngol, 2022; 279(9): 4325–33.
 
25.
Selaimen FA, Rosito LPS, Silva MNL, Silva AL, de Souza Stanham V, Costa SS. Central versus marginal tympanic membrane perforations: does it matter? An analysis of 792 patients. Acta Otolaryngol (Stockh), 2021; 141(2): 122–8.
 
26.
Afolabi OA, Aremu SK, Alabi BS, Segun-Busari S. Traumatic tympanic membrane perforation: an aetiological profile. BMC Res Notes, 2009; 2: 232.
 
27.
Kent DT, Kitsko DJ, Wine T, Chi DH. Frequency-specific hearing outcomes in pediatric type I tympanoplasty. JAMA Otolaryngol Neck Surg, 2014; 140(2): 106–11.
 
Journals System - logo
Scroll to top