Tympanoplasty - reporting hearing results and 'hearing objective'

When reporting the results of tympanoplasty, the postoperative air-bone gap (ABG) presented in 10 dB bins, ABG closure and air conduction threshold gain are commonly reported indicators of tympanoplasty outcome. When tympanoplasty is performed, the reconstruction aims either to improve hearing threshold or to maintain satisfactory thresholds, that is, the surgical intention is either for 'hearing gain' or for 'hearing preservation'. This review of the early results of tympanoplasty examines whether classifying surgery as either for hearing gain or for hearing preservation influences the reported results. Closure of the ABG to within 20 dB was achieved in 72-94% of cases, the average postoperative ABG was between 13.1 and 17.1 dB with the postoperative air conduction threshold being between 27.4 and 33.5 dB. These figures were similar for both hearing preservation and hearing gain procedures. However air conduction threshold gain was significantly greater for the 'hearing gain' group (17 dB versus 0 dB) and was reduced to 8 dB by combining the two groups. Overall, indicating whether surgery attempted hearing preservation or hearing gain did not significantly alter the parameters used for reporting tympanoplasty outcome.