Traumatic Perforation of Tympanic Membrane

Abstract

Introduction: Traumatic perforation of tympanic membrane (TM) is caused by increase in air pressure due to slapping, road traffic accident, blast injury, syringing, trauma by ear buds, etc., The incidence has been increased in recent times due to increased domestic violence and road traffic accidents. Hence, there is a need for early identification, evaluation, and management to reduce the morbidity. Objectives: The objective of the study was to describe etiologies of traumatic perforation of TM, to assess the findings of pure tone audiometry (PTA) among patients with traumatic perforation of TM, and to determine the outcome. Materials and Methods: This study was done between November 2017 and May 2019 in the department of ENT at Bangalore Medical College and Research Institute on 88 patients with traumatic perforation of TM who were subjected to otoscopic examination, tuning fork tests, and PTA. Patients were followed up on weekly basis. Results: Out of 88 patients, 33 patients (37.5%) were in the age group of 21–30 years. Fifty-four were males (61.36%) and 34 were females (38.63%). Slapping is the most common mode of injury with 50 (56.8%) patients. Left ear 55 (62.5%) was more commonly involved than right ear 33 (37.5%). Small perforation 55 (62.5%) was more common followed by medium-sized perforation 25 (28.4%) and large perforations were the least 8 (9.1%). Multiple quadrants were involved in 33 patients (37.5%). Posteroinferior quadrant was most commonly involved. Deafness (75%) was the most common symptom involving 66 patients. Average time taken for spontaneous healing was 37 days. Mean hearing improvement compared between hearing loss at the time of trauma and after 3 months was 13.18 ± 7.05 dB, which is statistically significant (P = 0.0001). Conclusion: Traumatic perforation of TM spontaneously healed in 80 participants (90.90%), whereas eight participants (9.09%) underwent surgery, i.e., tympanoplasty.