Traumatic Tympanic Membrane perforation: An aetiological profile

Abstract

BackgroundTraumatic perforation of the tympanic membrane may be due to direct or indirect source. The aim of the study is to profile the various aetiologies of traumatic tympanic membrane perforation in Ilorin, north central Nigeria.A retrospective review of 64 patients seen at the University of Ilorin Teaching hospital, Ilorin, Nigeria over a ten year period (January 1998 to Dec 2007) with history of traumatic tympanic membrane perforation from various causes, these also included multiply injured patients with bleeding from middle ear as part of their presentations. The data retrieved included the biodata, the clinical presentations, source of injury, the clinical findings and the treatment outcome. The data were entered into an SPSS version 11 computer soft ware and analyzed descriptively.FindingsSixty four (64) ears were analysed, Age range 6 months to 50 yrs, mean age of 29.2 yrs 7.9% of them were ≤5 years, 29.7% between 21-34 years, and 37.7% were 35 years and above. The male to female ratio was 2.5:1.0. Commonest aetiology was from slaps, then road traffic injury (RTI) in 35.9% and 23.5%, Majority of the slap injury were from fights (30.5%), security agents, senior students and cultists at schools (17.4% each). Sudden hearing loss was a typical presentation (95.3%), majority of the patient defaulted from follow up once the symptoms of bleeding and pain subsided. Only 7.8% had neomembrane formation on follow upConclusionTraumatic perforation of the tympanic membrane is an uncommon injury that is under-reported, there is the need to educate on alternative punitive measure among students and security agents, unskilled removal of foreign body, early identification, evaluation and referral of patients reduces the attendant morbidity.

Traumatic tympanic membrane perforations: characteristics and factors affecting outcome

“…Other reports had age ranges of 29.2 to 33.6 years. 15,16,17 The male preponderance found in our study resonates with that reported in a study in Ilorin, North-central Nigeria. 15 This may be due to more outdoor activities in males than the females.…”

“…Exploration of the causes and mechanisms of TTMP revealed a trend similar to those reported from other studies. 15,18 Assault (altogether 50.9%) was a common and prominent cause of TTMP in this study like in other previous reports (37.4-86.4%). 16,19,20 Assaults ranged from domestic attacks like slaps from spouse and armed bandits, to injuries inflicted by state security personnel.…”

Self-inflicted negative pressure of the external ear canal: a rare cause of tympanic membrane perforation

“…[11][12][13] The presenting symptoms of traumatic TMP and their frequency were hearing loss (95.3%), bleeding (68.8%), CSF leak (15.6%), dizziness (9.4%), tinnitus (52%), infection (37.5%), and pain (59.4%). [5] Both our patients had ear pruritus. One patient had eczematous external otitis and the other suffered from AR.…”

“…[5] In another retrospective analysis of 198 patients with traumatic TMP, the causes and frequencies of the traumatic TMPs were as follows blow (n=90), collision (n=40), insertion of cotton bud (n=36), insertion of sharp object (n=9), firecracker explosion (n=5), barotrauma (n=4), kick by a child (n=2), weld bead (n=2), and unknown (n=10) and 45.5%, 20.2%, 18.1%, 4.5%, 2.5%, 2%, 1%, 1%, and 5% respectively. [6] Overpressure is the most common mechanism of trauma to the TM.…”

“…[6] Overpressure is the most common mechanism of trauma to the TM. [4][5][6][7][8] It was shown that rupture of normal TMs in cadavers was performed at an In addition to this, the membrane's tensile strength declines with advancing age. [9] Several factors have proven to positively or negatively affect an individual's susceptibility to TMP.…”