Characterization of Tympanic Membrane Perforation in Patients with Chronic Suppurative Otitis Media without Cholesteatoma

Background: The middle ear and external ear are separated by the tympanic membrane. Tympanic membrane perforation is a common cause of conductive hearing loss, with its size being a critical factor in the extent of hearing loss. Aim: This study assessed the burden of hearing loss in patients with tympanic membrane perforation from chronic suppurative otitis media without cholesteatoma, aiming to improve outcomes and reduce complications. Patients and methods: This cross-sectional descriptive study involved 198 patients with tympanic membrane perforation who presented at the ENT clinic of Suez Canal University, documenting clinical findings indicative of the condition. Results: This study involved patients with a mean age of 34.2 years, comprising 43.4% males and 56.6% females, with 45.5% from low socioeconomic status. The age group of 25-34 years experienced the highest average hearing loss of 45 dB. Left ear involvement was noted in 52.5% of cases, with 67.7% having central tympanic membrane perforation. Furthermore, 41.4% had perforations ranging from 25 to 50%, and 27.3% ranged from 50 to 75%, with 34.3% showing irregular shapes. The study concluded that larger tympanic membrane perforations are associated with greater hearing loss compared to smaller sizes. Conclusion: Our research indicates that perforation size influences the level of hearing impairment, with conductive hearing loss being the most common type observed. The location of the perforation also significantly affects the degree of hearing loss, particularly in cases of posteroinferior perforations compared to central and superior ones. Further larger studies are required to validate these findings.