# Systematic Review and Meta‐Analysis of Audiometric Parameters for Assistive Hearing Technology for Adults and Children With Tympanic Membrane Perforation

## TL;DR

This study reviews hearing loss data in people with eardrum perforations to guide the development of hearing aids and other assistive technologies.

## Contribution

The study provides the first systematic review and meta-analysis of audiometric data for hearing technology rehabilitation in tympanic membrane perforation.

## Key findings

- Adults with eardrum perforations have an average air conduction hearing threshold of 48.3 dB HL.
- Children with eardrum perforations have better hearing thresholds compared to adults, both in air and bone conduction.
- Most individuals with eardrum perforations can benefit from either air or bone conduction hearing devices.

## Abstract

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.