Impact of Evolution of the Eardrum Bridge on the Healing Process of Traumatic Eardrum Perforation

Abstract

Objectives: Characterize the otoendoscopic features of traumatic tympanic membrane perforations (TMPs) with an “eardrum bridge” and evaluate the evolution of the eardrum bridge during the spontaneous healing process. Methods: Data for 427 patients with barotrauma-associated traumatic TMPs who met the case selection criteria were retrieved and categorized into two groups: those with and those without an eardrum bridge. Results: Of the 427 patients with traumatic TMPs during the two-year study period between January 2006 and December 2007, only 36 (8.4%) had an eardrum bridge. For small-sized perforations, the overall closure rate was significantly different (100% versus 87.7%, P=0.03) between those with and without an eardrum bridge. However, the average closure time was not significantly different (21.2 versus 26.8 days, P>0.05), although the mean closure in cases with an eardrum bridge was shortened by 5 days compared to that in cases without an eardrum bridge. For medium and large perforations, statistical analysis was not performed due to the much smaller number of cases with eardrum bridges. Conclusions: Eardrum bridge with traumatic TMP can result in necrosis, migration of stratified epithelium, and epithelium proliferation during the healing process. However, the eardrum bridge seems to improve the healing rate of traumatic perforations.