Abstract

Traumatic tympanic membrane (TM) perforation has long been a challenge to the otologist, the objective of this study was to evaluate the prevalence of spontaneous healing of traumatic TM perforation and the factors influenced this healing process. This was a hospital based prospective study performed in the Department of ear, nose and throat (ENT), Al-Fallujah Teaching Hospital, Al-Anbar, Iraq, from August 2011 to April 2013, during this period 60 patients diagnosed having traumatic perforation of TM (62TM) due to bilateral affection in two patients. All those patients treated conservatively with systemic antibiotics, avoidance of let water in the ear and follow up for three months. The commonest cause of perforation was slap injuries (29%), perforation by solid objects (25.8%), explosion (16.1%), fall from height (12.9%), road traffic accident (9.7%), syringing (4.85%) and swimming (1.6%). The healing rate of perforated TM after three months of follows up was 82.3% (51 of 62 TM). There was no statistically significance difference between patients with, or without spontaneous healing of TM regarding the gender of the patient, laterality and causes of the injury (p>0.05). There was statistically significant difference between patients with, or without spontaneous healing of TM regarding age of the patient, severity of deafness, size of perforation (p <0.05). From this study we concluded that the chances of spontaneous healing of traumatic TM perforation were very high, so that, early surgical intervention of traumatic TM perforation is not indicated.

Highlights

  • The tympanic membrane (TM) is an important component of sound conduction as its vibratory characteristic is necessary for sound transmission in human beings [1]

  • This study was approved by ethics committee of the hospital and informed consent had been taken from each patient, during this period 65 patients diagnosed having TM traumatic perforation for different reasons

  • The total number of the patients with traumatic TM perforations was 60 patients, they ranged from seven year to above 60 years old, and the mean age with standard deviation was 22 years ± 2.2 years

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Summary

Introduction

The tympanic membrane (TM) is an important component of sound conduction as its vibratory characteristic is necessary for sound transmission in human beings [1]. Traumatic perforations of TM are not uncommon injuries. Rupture of the TM may be caused by changes in the air pressure (blow on the ear, blast injury, Eustachian tube inflation, nitrous oxide anesthesia and hyperbaric oxygen treatment), by fluids (syringing, caloric tests and in diving) or by solid objects (instrumentation attempts at foreign body removal, match sticks, hair clips and sparks of hot metal) [2]. Traumatic perforations often occur in healthy members of the community: generally the prognosis is excellent. Most of traumatic tympanic membrane perforations usually spontaneously heal and returns to normal membrane function. Small perforations are more likely to close spontaneously than large ones [2]. The two main factors leading to failure of the perforations to heal are loss of tissue and secondary infection [3]. Surgical intervention for perforation should be undertaken in the rare cases when these conditions persist greater than six months [3]

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