Hampton Thomas, Sanderson Alan, Mortimer Kevin, Bhutta Mahmood
Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
Clin Otolaryngol. 2025 Jul;50(4):589-599. doi: 10.1111/coa.14295. Epub 2025 Mar 2.
Tympanic membrane perforation can cause hearing impairment with detrimental effects on communication and quality of life, and is a problem affecting an estimated 250 million people. To date, there is little analysis to inform public policy on options for assistive hearing technology rehabilitation in this group.
We undertook a systematic review and meta-analysis of six electronic databases registered with PROSPERO and reported in accordance with PRISMA 2020 standards. The primary outcome was the mean air and bone conduction hearing threshold associated with tympanic perforation.
Of 720 studies identified, 16 contained data for meta-analysis. Mean air conduction threshold was 48.3 dB HL in adults and 31.9 dB HL in children. Mean bone conduction was 26.6 dB HL in adults and 9.5 dB HL in children. The prediction interval was -1.7 to 46.7 dB HL for bone conduction and 15.0-70.5 dB HL for air conduction.
The majority of adults and children with tympanic perforation have air conduction thresholds within the range of rehabilitation with air conduction hearing aids. The majority also have good sensorineural hearing reserve, meaning bone conduction devices are also suitable. Our analysis can guide the development of affordable technology for the rehabilitation of those with tympanic perforation.
鼓膜穿孔可导致听力障碍，对沟通和生活质量产生不利影响，是一个影响约2.5亿人的问题。迄今为止，几乎没有分析可为该群体辅助听力技术康复方案的公共政策提供参考。
我们对在PROSPERO注册的六个电子数据库进行了系统评价和荟萃分析，并按照PRISMA 2020标准进行报告。主要结局是与鼓膜穿孔相关的平均气导和骨导听力阈值。
在识别出的720项研究中，16项包含荟萃分析的数据。成人平均气导阈值为48.3dB HL，儿童为31.9dB HL。成人平均骨导为26.6dB HL，儿童为9.5dB HL。骨导的预测区间为-1.7至46.7dB HL，气导为15.0 - 70.5dB HL。
大多数鼓膜穿孔的成人和气导阈值在气导助听器康复范围内，大多数也有良好的感音神经性听力储备，这意味着骨导装置也适用。我们的分析可为开发适用于鼓膜穿孔患者康复的经济适用技术提供指导。
