title: Outcomes for conservative management of traumatic conductive hearing loss.
abstract: OBJECTIVE
  To evaluate the natural history of traumatic conductive hearing loss.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Otologic and audiometric evaluations of patients in the early posttraumatic phase were compared with evaluations at follow-up. Assessment included etiologies of trauma, classification of hearing loss, factors causing conductive loss, and analyses of changes in air-bone gaps, pure-tone averages and hearing loss class.
  
  
  RESULTS
  There were 45 patients, representing 47 ears, with sufficient initial and follow-up documentation to analyze the natural history of traumatic conductive hearing loss. Overall, 77% of ears showed an improvement in pure-tone averages without surgical intervention. Air-bone gaps closed from an average of 24.8 +/- 12.1 to 13.2 +/- 11.1 dB. Only 11% of ears demonstrated a decrease in pure-tone averages, and 12% showed no change in thresholds. All forms of injury contributing to the conductive hearing loss had good outcomes. Specifically, tympanic membrane perforations showed final air-bone gaps of 14.9 +/- 11.2 dB; cases of hemotympanum had final air-bone gaps of 10.0 +/- 8.1 dB; and suspected ossicular chain disruptions had final air-bone gaps of 13.9 +/- 12.3 dB. Only 5 of 47 ears ultimately required surgical intervention for persistent pathology.
  
  
  CONCLUSIONS
  Patients with all forms of traumatic conductive hearing loss can be initially managed conservatively. Even suspected ossicular chain disruptions have a high rate of spontaneous reparation. Surgical intervention for perforation or conductive hearing loss should be undertaken in the rare cases when these conditions persist greater than 6 months.
authors.affiliation: Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA.
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Grant
authors.forename: Jill
authors.initials: J
authors.lastname: Arganbright
authors.forename: David R
authors.initials: DR
authors.lastname: Friedland
mesh_terms: D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D001844:Bone Conduction; D006259:Craniocerebral Trauma / Q000150:complications*; D006314:Hearing Loss, Conductive / Q000209:etiology* / Q000601:surgery / Q000628:therapy*; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy; D006801:Humans; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013701:Temporal Bone / Q000293:injuries*; D016896:Treatment Outcome; D018058:Tympanic Membrane Perforation / Q000209:etiology / Q000601:surgery / Q000628:therapy; D014433:Tympanoplasty