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<p>To study correlation of hearing loss by pure tone with speech audiometry among adults with chronic otitis media (COM). Prospective observational study of 60 adults with COM was done. Hearing threshold was evaluated with pure tone audiometry and speech audiometry with speech reception threshold (SRT) and speech discrimination score (SDS). Twenty four patients (ears) who underwent tympanoplasty +/- mastoidectomy had three months post-operative pure tone average (PTA) and speech audiometry too. There were 60 patients with COM, (35 unilateral and 25 bilateral), with 85 diseased ears, 89.4% being mucosal and 10.58% squamous type. Majority (44.7%) had mild, 21.1% moderately severe, 17.6% moderate and 16.8% minimal hearing loss. Comparing Pure Tune Average (PTA) to SRT &gt; +/- 12 dB and SDS &lt; 80%, among 85 ears, nine patients with &gt; 55dBHL revealed abnormal SRT and SDS. Among 24 postoperative ears, all had preoperative pure tone average of 36 dB HL, SRT of 30 dB and SDS 87%. They improved in PTA with mean of 15 to 20 dB and SDS &gt; 10% compared to their pre-operative values. Our study of patients with COM revealed that PTA did not reflect the impact of hearing loss on speech and communication as when PTA increased more than 55 dB HL, SDS decreased. Hence, speech audiometry is indicated especially when PTA threshold is &gt; 55 dB to rule out associated SDS reduction. Hearing loss around 35 dB had best chance of post operative normal hearing with speech comprehension as improvement in SDS and SRT. Hearing thresholds of 50 dB HL can be considered as a semi-urgent indicator for surgical intervention in mucosal COM to avoid reduction in speech comprehension for better chance of postoperative hearing and communication.</p>

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The Underrated Speech Audiometry in Chronic Otitis Media: A Correlational Study with Pure-tone Audiometry

  • 期刊论文

  • 发表日期：

    2026年2月7日

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  • Magesh Kuppusami,
  • Rajarajeswari Nalamate,
  • B. Bency Mary,
  • Mary Kurien,
  • K Pradeep,
  • Feba Ann Mary,
  • Glynis F. Francis,
  • Lakshana Deve,
  • Sithanandakumar Venkatesan

摘要

To study correlation of hearing loss by pure tone with speech audiometry among adults with chronic otitis media (COM). Prospective observational study of 60 adults with COM was done. Hearing threshold was evaluated with pure tone audiometry and speech audiometry with speech reception threshold (SRT) and speech discrimination score (SDS). Twenty four patients (ears) who underwent tympanoplasty +/- mastoidectomy had three months post-operative pure tone average (PTA) and speech audiometry too. There were 60 patients with COM, (35 unilateral and 25 bilateral), with 85 diseased ears, 89.4% being mucosal and 10.58% squamous type. Majority (44.7%) had mild, 21.1% moderately severe, 17.6% moderate and 16.8% minimal hearing loss. Comparing Pure Tune Average (PTA) to SRT > +/- 12 dB and SDS < 80%, among 85 ears, nine patients with > 55dBHL revealed abnormal SRT and SDS. Among 24 postoperative ears, all had preoperative pure tone average of 36 dB HL, SRT of 30 dB and SDS 87%. They improved in PTA with mean of 15 to 20 dB and SDS > 10% compared to their pre-operative values. Our study of patients with COM revealed that PTA did not reflect the impact of hearing loss on speech and communication as when PTA increased more than 55 dB HL, SDS decreased. Hence, speech audiometry is indicated especially when PTA threshold is > 55 dB to rule out associated SDS reduction. Hearing loss around 35 dB had best chance of post operative normal hearing with speech comprehension as improvement in SDS and SRT. Hearing thresholds of 50 dB HL can be considered as a semi-urgent indicator for surgical intervention in mucosal COM to avoid reduction in speech comprehension for better chance of postoperative hearing and communication.