Hearing Loss Due to Myringotomy and Tube Placement and the Role of Preoperative Audiograms

Authors:
  • PWPeter C. Weber
    Peter C. Weber
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Abstract
OTITIS MEDIA (OM) is one of the most frequent diseases of childhood, affecting at least 80% of children prior to school entry.1-4 Because of the high incidence of OM in children, each year billions of dollars are spent in the medical and surgical treatment of OM. Surgical treatment of chronic OM via myringotomy and tympanostomy tube insertion (MTT) is one of the most commonly performed operations in the United States.2,5,6 The potential risks, complications, and benefits of MTT are well documented in the literature.5,7-10 The 3 most common risks associated with MTT are postoperative otorrhea, tympanosclerosis, and persistent tympanic membrane perforation. The risk of hearing loss is routinely discussed with any patient (or parent) about to undergo an otologic procedure, including MTT. Although the risk of hearing loss is largely considered theoretical for MTT, many otolaryngologists routinely perform preoperative and postoperative audiometric studies to document the patient's preoperative hearing status and whether it has either improved or remained stable after MTT. A recent report by Manning et al11 demonstrated a 1% incidence of preoperative sensorineural hearing loss (SNHL) in children undergoing MTT. However, no postoperative analysis was discussed. To our knowledge, no large study has been done to document the incidence of postoperative SNHL or conductive hearing loss (CHL) with MTT.

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