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Introduction <p>Tympanoplasty is a surgical procedure designed to reconstruct the tympanic membrane and restore auditory function in patients with chronic suppurative otitis media (CSOM). While anatomical restoration is the primary goal, long-term functional outcomes depend significantly on the biomechanical and acoustic properties of the middle ear, particularly middle ear compliance. This study evaluates the prognostic value of achieving normal middle ear compliance following tympanoplasty and its correlation with postoperative hearing improvement.</p> Methods <p>A prospective observational study was conducted in the Department of Otorhinolaryngology at Dr. KNS Memorial Institute of Medical Sciences, Barabanki, from June 2022 to July 2024. A total of 72 adult patients (aged 18–60 years) with CSOM and dry ear for at least six weeks underwent tympanoplasty with or without cortical mastoidectomy. Pre- and postoperative assessments included pure tone audiometry (PTA) and tympanometry at 3- and 6-months post-surgery. Middle ear compliance was evaluated using tympanogram types, and hearing improvement was assessed through changes in air conduction (AC) and air-bone gap (ABG). Statistical correlation between compliance and hearing outcomes was analysed using the Chi-square test.</p> Results <p>Postoperative tympanometry revealed a shift to Type A tympanogram in 10 patients, reflecting restored middle ear compliance. This was associated with significant improvement in AC thresholds (mean: 41.99 dB to 28.63 dB) and ABG reduction (26.83 dB to 13.79 dB). Patients with Type A tympanograms demonstrated the most pronounced ABG closure, whereas those with Type B or C patterns showed persistent conductive deficits. These findings confirm the prognostic significance of achieving normal middle ear compliance in optimizing auditory outcomes post-tympanoplasty.</p> Conclusion <p>Normal middle ear compliance, as evidenced by a Type A tympanogram, serves as a strong prognostic indicator for successful hearing improvement following tympanoplasty. Postoperative tympanometry should be incorporated into routine follow-up to guide patient management and identify those at risk for suboptimal outcomes.</p>

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Evaluation of Middle Ear Compliance Post-Op and Its Association with Hearing Improvement Post-Op

  • 期刊论文

  • 发表日期：

    2025年10月14日

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  • Shalini Singh,
  • Sumit Sharma,
  • B. P. Singh,
  • Ahmed Aseem Naseem,
  • Third Year

摘要

Introduction

Tympanoplasty is a surgical procedure designed to reconstruct the tympanic membrane and restore auditory function in patients with chronic suppurative otitis media (CSOM). While anatomical restoration is the primary goal, long-term functional outcomes depend significantly on the biomechanical and acoustic properties of the middle ear, particularly middle ear compliance. This study evaluates the prognostic value of achieving normal middle ear compliance following tympanoplasty and its correlation with postoperative hearing improvement.

Methods

A prospective observational study was conducted in the Department of Otorhinolaryngology at Dr. KNS Memorial Institute of Medical Sciences, Barabanki, from June 2022 to July 2024. A total of 72 adult patients (aged 18–60 years) with CSOM and dry ear for at least six weeks underwent tympanoplasty with or without cortical mastoidectomy. Pre- and postoperative assessments included pure tone audiometry (PTA) and tympanometry at 3- and 6-months post-surgery. Middle ear compliance was evaluated using tympanogram types, and hearing improvement was assessed through changes in air conduction (AC) and air-bone gap (ABG). Statistical correlation between compliance and hearing outcomes was analysed using the Chi-square test.

Results

Postoperative tympanometry revealed a shift to Type A tympanogram in 10 patients, reflecting restored middle ear compliance. This was associated with significant improvement in AC thresholds (mean: 41.99 dB to 28.63 dB) and ABG reduction (26.83 dB to 13.79 dB). Patients with Type A tympanograms demonstrated the most pronounced ABG closure, whereas those with Type B or C patterns showed persistent conductive deficits. These findings confirm the prognostic significance of achieving normal middle ear compliance in optimizing auditory outcomes post-tympanoplasty.

Conclusion

Normal middle ear compliance, as evidenced by a Type A tympanogram, serves as a strong prognostic indicator for successful hearing improvement following tympanoplasty. Postoperative tympanometry should be incorporated into routine follow-up to guide patient management and identify those at risk for suboptimal outcomes.