Management of Traumatic Perforations of the Tympanic Membrane: A Clinical Study

Abstract

Objective To compare the outcome of conservative management vs surgical intervention (realignment of torn edges) in traumatic perforations of the tympanic membrane (TM). Design Cohort study, Interventional, Observational, Prospective. Setting Karnataka Institute of Medical Sciences, Hubli, Karnataka. Patients All patients attending the Department of Otolaryngology with otological injuries. Interventions Patients with isolated traumatic tympanic membrane perforations without evidence of temporal bone fractures were managed either conservatively or surgically by realigning the torn edges of perforation under local anesthesia and supporting with gelfoam. Main outcome measures Healing of perforation, duration taken for complete healing and hearing outcome by pure tone audiometry. Results Perforations in patients taken up for surgical intervention healed faster. Though the difference in outcome, i.e. healed TM perforation between the 2 groups was not statistically significant, the difference in duration taken for healing was observed to be statistically significant (p < 0.05). Conclusion Minimal surgical intervention involving realignment of torn edges of perforation and supporting with gelfoam enables faster healing. How to cite this article Saimanohar S, Gadag RP, Subramaniam V. Management of Traumatic Perforations of the Tympanic Membrane: A Clinical Study. Int J Otorhinolaryngol Clin 2015;7(3):114-116.

Incidence and characteristics of Traumatic Tympanic Membrane perforation

“…The commonest cause of perforation of tympanic membrane was slap (35, 72.9%), followed by blast injury (4, 8.3%) in this study, that is in conformity with results of Rabbani SMG, Onotai LO, Wani A, Saimanohar S, Sarojamma Q and Perera MC where slapping accounts 88.5%, 42.86%, 69.42%, 86.67%,50% and 75% respectively. 1 , 3 - 5 , 9 , 10 However it is contrary to study of Dawood from Iraq where blast injury was common 43. 50% than slap 25.80% leading to TM perforation, because blasts are common in Iraq which is in a state of war for last so many years.…”

“… 4 The traumatic TM perforation is classified according to duration, acute (< 3 months) and chronic (> 3 months) and by the presence or absence of otorrhea in wet and dry perforation respectively. 5 The perforation can also be classified according the size. The two commonly used method of calculating size are:…”