Wound edge characteristics at different clinical periods and intervention of traumatic perforation of tympanic membrane

Abstract

Objective To discuss wound edge characteristics at different clinical periods and in-tervention of traumatic perforation of tympanic membrane. Methods A total of 494 patients wth trau-matic perforation of tympanic membrane were treated and grouped based on treatment time and size of per-foration. Group A (n = 154, within 12 hours after injury) were treated by residual tympanic membrane repair and gelfoam. Group B (n =149, 12 hours after injury) were treated by simple gelfoam. Group C (n = 116) and Group D (n =75) were treated by conventional therapy. The wound healing of peroration was observed after one month. Results Of all, there were 419 patients with maximum perforation diameter > 2.5 mm within five hours after injury, of which 349 patients (83.3%) were with residual tympanic membrane valgus of perforation rim, 29 (6.9%) with involution of perforation rim and 41 (9.8%) with complete loss of tympanic membrane. Of 75 patients with maximum perforation diameter <2.5 ram, residual valgus of perforation rim was found in 18 (24.0%) and tympanic membrane wrinkle near wound edge in the other patients. Under endoscopic repair of crimp tympanic membrane, maximum perforation diameter was reduced for (6.5±2.5)mm in 143 patients at 6th hour, (6.0±1.5)mm in 11at 7-11 hours, (2.0±1.5) mm in 27 at 13-24 hours, (1.5±1.0) mm in 59 at 25.5-48 hours, (1.0±0.5) mm in 49 at 51-73 hours and 0 mm in 14 at 75-192 hours. The follow up lasted for one month, which showed that healing rate of perforation in groups A, B, C and D were 85.3%, 71.2%, 59.2% and 81.4%, respectively. Healing time span was (10±4) days, (19±4) days, (25±2) days and (16±2) days, respectively. Conclusions Traumatic perforation of tympanic membrane is not com-plete tympanal deletion but residual tympanic membrane valgus of perforation rim,involution and tympanicmembrane crushing, which shows insignificant change with time. In time repair of residual tympanic membrane 12 hours(especially 6 hours) after injury may reduce the largest diameter of perforation and re-markably shorten the healing time of perforation. Key words: Perforation,tympanic membrane; Wounds and injuries; Intervention