Prognosis and Outcome of the Tympanic Membrane Flap at Traumatic Tympanic Membrane Perforation Edge

Abstract

This study aimed to retrospectively evaluate the prognosis and outcome of tympanic membrane perforations with a particular focus on the fate of the perforation edge flaps.Chart records of 329 patients with a single ear traumatic tympanic membrane perforation were retrieved and analyzed. Of these patients, 70 were left to heal spontaneously, 93 received gelatin sponge patching treatment and 114 were subjected to otoendoscopic eardrum repair before gelatin sponge patching. The complete perforation closure rate at 3 months was 94.29% (66/70), 98.92% (92/93) and 98.24% (112/114) in the 3 groups, respectively, with no statistically significant difference (p = 0.608). The mean closure time was 28.2 ± 3.6 days in the spontaneous healing group, which was significantly longer than that in the sponge patching group (11.1 ± 2.1 days, p = 0.0017) and in the eardrum repair + sponge patching group (12.5 ± 1.9 days, p = 0.0032), while there was no significant difference between the 2 gelatin sponge patching groups (p = 1.86). The hearing ability improved in the 3 groups (6.4 ± 0.83, 7.2 ± 1.65 and 9.6 ± 2.37 dB, respectively), with no statistically significant difference (p >0.05). In the gelatin sponge patching group, new tympanic membrane tissue of the eardrum flap edge proliferated, and the contour of the eardrum flap was not obvious. In the eardrum flap repair group, the eardrum flap retracted to the perforation edge. In conclusion, the eardrum flap of the perforation edge does not have any obvious effect on the perforation closure so that it is unnecessary to conduct an intervention procedure on the flap in the clinical treatment.