Purpose: This study is directed towards establishing a correlation between the objective measurement of tympanic membrane (TM) perforation size with hearing loss in patients with inactive mucosal chronic otitis media (COM), and to compare the otoscopic findings of the TM perforation vis-a-vis the results obtained by image analysis of the endoscopic image of the perforation. Materials and methods: An observational, prospective and hospital based study was performed on 107 ears (78 patients) with inactive mucosal chronic otitis media. Objective measurement of the TM perforation size was done by capturing the images of the perforation on ImageJ analysis software. A correlation was established between the hearing loss and the perforation with respect to its size and location. The accuracy of the otoscopic finding of the perforation was established with respect to the endoscopic image of the perforation. Results: The extent of the hearing loss was seen to increase with increasing size of the TM perforation (r = 0.435, p
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