High-Frequency Conductive Hearing following Total Drum Replacement Tympanoplasty

Area of Science:

• Otolaryngology
• Audiology
• Surgical Outcomes

Background:

• Conventional reporting of post-tympanoplasty hearing outcomes focuses on low-frequency air-bone gap (ABG).
• High-frequency conductive hearing outcomes after tympanoplasty are less frequently reported.
• This study investigates high-frequency ABG following temporalis fascia total drum replacement.

Purpose of the Study:

• To evaluate high-frequency air-bone gap (ABG) in patients undergoing temporalis fascia total drum replacement.
• To compare pre- and postoperative high-frequency ABG.
• To assess the limitations of conventional ABG reporting in capturing high-frequency hearing changes.

Main Methods:

• A case series with chart review was conducted at a tertiary care center.
• Patients undergoing type 1 tympanoplasty with lateral graft total drum replacement (August 2016-February 2019) with pre- and postoperative audiograms were included.
• Low-frequency ABG was calculated at 250, 500, and 1000 Hz; high-frequency ABG was calculated at 4 KHz.

Main Results:

• Twenty-three patients (mean age 44 years) with trauma or chronic otitis media were analyzed.
• Postoperative low-frequency ABG significantly improved (reduced by 15.5 ± 13.3 dB, P < .001).
• High-frequency ABG showed an insignificant change postoperatively (reduced by 2.6 ± 16.2 dB, P = .450), indicating persistent high-frequency conductive hearing loss.

Conclusions:

• Temporalis fascia total drum replacement improves low-frequency hearing but does not significantly alter high-frequency ABG.
• Conventional ABG reporting may obscure persistent high-frequency conductive hearing loss.
• Further research is warranted across diverse tympanoplasty techniques and graft materials to address high-frequency hearing outcomes.