RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA.

ANNEXURE II PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1. NAME OF THE CANDIDATE AND ADDRESS DR. VIDYA JANAKI. R. PG IN ENT, KARNATAKA INSTITUTE OF MEDICAL SCIENCES, HUBLI 580 0 . KARNATAKA INSTITUTE OF MEDICAL SCIENCES, HUBLI! . M.S. IN ENT. 10!0$! 008. CORRELATION OF SITE AND SI%E OF TYMPANIC MEMBRANE PERFORATION &ITH PURE TONE AUDIOGRAM.

NAME OF THE INSTITUTION

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COURSE OF THE STUDY AND SUBJECT DATE OF ADMISSION TO THE COURSE TITLE OF THE TOPIC

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BRIEF RESUME OF INTENDED &ORK' $.1 NEED FOR THE STUDY' Chronic suppurative otitis media(CSOM) is a wide spread disease of the developing countries like India especially in the rural areas. It is one of the commonest causes of hearing loss that mainly results due to a tympanic membrane perforation. he large effective surface area of an intact and normally vibrating tympanic membrane plays a ma!or role in the middle ear transformer mechanism. "erforation of the tympanic membrane is a common cause for hearing loss due to loss of effective area of vibration. "erforations can result from various reasons including middle ear disease# trauma. It has been generally believed that the degree of hearing loss increases with

the si$e of the perforation. Many prior clinical studies have shown that hearing loss associated with perforation was more at low fre%uencies than at high fre%uencies and it increases with the si$e of perforation. Correlation of the site of perforation to hearing loss is not very clearly established though a few studies have shown no significance of site of perforation. &nother showed postero inferior perforation caused more hearing loss than others. &ccurate assessment of the M "erforation and its relationship with hearing loss is important as it enables the clinician to optimally assess the condition and offer an appropriate solution. 'ence the need for the study.

$. REVIE& OF LITERATURE' (. In ()*)# &hmad.S.+ and ,amani -. . studied */ patients with dry central perforations to assess the hearing loss and concluded that hearing loss was greater at the lower fre%uencies and increases with the si$e of the perforation. hey also found that posteroinferior %uadrant perforations caused more hearing loss than antero inferior ones# the difference being greater at lower than at higher fre%uencies.( 0. In 0//1# ,itvik " Mehta# ,osowski 2 2ohn et al conducted a study on 31 patients with isolated M "erforations and showed that hearing loss is fre%uency dependant and the greatest loss occurred at the lowest fre%uencies# hearing loss increased with increase in si$e of perforation# varied inversely with middle ear volume and does not vary substantially with location of the perforation.0 4. In 0//4# 5husal C 6 et al studied fifty patients with CSOM 7 ubo tympanic type undergoing myringoplasty and showed that hearing loss was more at lower fre%uencies and less as fre%uencies increase and hearing loss increased with the si$e of perforation.4 8. In 0//( #.oss S 9# ,osowski 22 et al measured acoustic transmission before and after making controlled perforations in cadaver ears and showed that perforations caused fre%uency dependent loss that was largest at low fre%uencies #increased as the si$e of perforation increased and did not depend on perforation location.8 3. In ()*0# +alter " et al studied the effects of both si$e and location of tympanic

membrane perforations on hearing loss in (/4 patients who had undergone myringoplasty and concluded that effectiveness of the M decreased with loss of total area.3 $." AIMS OF THE STUDY' (. 0. o record the site and si$e of tympanic membrane perforations. o correlate the site and si$e of the perforation with pure tone audiogram in such patients who fulfilled the study criteria..

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MATERIALS AND METHODS' (.1 SOURCE OF DATA' "atients attending 9: O"; in <IMS# 'ubli in the study period from 2anuary 0//) to ;ecember 0//) who have a tympanic membrane perforation.

(. METHODS OF COLLECTION OF DATA' & cross sectional# correlative study is planned. 9very consecutive eligible patient will be recruited into the study and divided into two to three groups depending on the si$e of the perforation. he site of perforation will also be recorded and a pure tone audiogram will be performed on the patient. he data obtained will be analy$ed using an appropriate statistical test.

INCLUSION CRITERIA' (. Sub!ect should have central M perforation due to trauma or CSOM. 0. &ll sub!ects should have dry ears ( duration 4 months ) 4. "atients with intact ossicular chain= confirmed by patch test. 8. &ge between (/ to 1/ years.

EXCLUSION CRITERIA'

(. "atients with &ttico= antral disease= presence of cholesteatoma or granulation tissue. 0. &ctive CSOM. 4. "atients with ossicular chain pathology. 8. "atients who cannot give a valid and consistent " & response. 3. "atients with sensorineural hearing loss.

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DOES

THE

STUDY

RE)UIRE

ANY

INVESTIGATIONS

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INTERVENTIONS TO BE CONDUCTED ON PATIENTS OR OTHER HUMANS OR ANIMALS* IF SO, PLEASE DESCRIBE BRIEFLY. +Y,-. "ure tone audiometry and patch test.

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HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION IN CASE OF (."* Y,-, 9thical clearance has been obtained from ethical committee of <IMS# 'ubli.

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LIST OF REFERENCES'

(. &hmad S + and ,amani - . >'earing loss in perforations of the tympanic membrane.? he 2ournal of 6aryngology and Otology ()*)@)4@(/)(=(/)A. 0. ,itvik " Mehta et al >;eterminants of hearing loss in perforations of the tympanic membrane.? Otology and :eurology 0//1@0*@(41=(84. 4. 5husal et al >Si$e of tympanic membrane perforation and hearing loss.? 2:M& 2 :epal Med &ssoc. 0//1@83((1()@(1*=(*0. 8. .oss S 9 et al >'ow do tympanic membrane perforations affect human middle ear sound transmissionB?&cta otolaryngol. 0//( !an@(0((0)C(1)=*4. 3. +alter " &nthony et al > ympanic membrane perforation? &rchives of

otolaryngology ()*0@vol )3 C3/8=3(/. 1. &!ith kumar D and .ikram 5hat <. >;o the site and si$e of tympanic membrane perforation correlate with audiogramB?&sian !ournal of 9ar#:ose and 0///@8@03=4/. *. .ikram 2 2aisinghani et al >%uantitative analysis of tympanic membrane disease using video 7otoscopy? he 6aryngoscope 0/// octC((/C(*01=(*4/. A. Ibeweke S et al >%uantitative analysis of tympanic membrane perforationCa simple and reliable method. he !ournal of laryngology and otology 0//A oct 00C(=8 . ). Ibeweke S et al >assessments of the si$e of tympanic membrane perforationsCa comparison of clinical estimations with video otoscopic calculations. 9ar :ose and hroat 2ournal. 0//A octCA*((/)C31*=31). (/. "ayne M C and -lither E 2 ()3( archives of otolaryngology# 38 111=1*8. hroat

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SIGNATURE OF THE CANDIDATE

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REMARKS OF THE GUIDE

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NAME AND DESIGNATION OF DR. VIKRAM K BHAT MS, DNB, P01. THE GUIDE ASSOCIATE PROFESSOR OF ENT DEPARTMENT OF ENT, KIMS, HUBLI. SIGNATURE

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HEAD OF THE DEPARTMENT

DR. UMESH S NAGALOTIMATHMS,DNB PROFESSOR 2 HEAD, DEPARTMENT OF ENT, KIMS, HUBLI.

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REMARKS OF THE CHAIRMAN AND THE PRINCIPAL

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