Traumatic tympanic membrane perforations: a study of etiology and factors affecting outcome

Lou, Zhengcai; Lou, Zihan; Zhang, Qingping

doi:10.1016/j.amjoto.2012.01.010

Cited by 77 publications

(90 citation statements)

References 18 publications

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“…With multivariate analysis, we found that perforation size was the single determining factor related to closure time, a finding also reported in some other studies. 2,4 In addition, some authors have stressed the negative influence of ear discharge and increasing age on closure time. 3,4 We found no obvious importance of perforation location, a finding supported by others.…”

Section: Discussionmentioning

confidence: 99%

“…The spontaneous closure rates and closure times in the present study are in accordance with results from other studies. [1][2][3]5 Several factors might be important determinants of closure time, such as age, ear discharge and perforation size. With multivariate analysis, we found that perforation size was the single determining factor related to closure time, a finding also reported in some other studies.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Studies comparing outcomes after observation only versus different active surgical interventions using various techniques have shown spontaneous closure rates between 53 and 86 per cent in the observation only groups, 8 and closure rates between 88 and 100 per cent in the operated groups. 2,6,9,10 However, different observation times were used in the various studies.…”

Section: Introductionmentioning

confidence: 99%

“…1 Subsequent studies showed similar findings, with spontaneous closure rates ranging from 80 to 97 per cent. [2][3][4][5] For cases of large perforations and blast injuries, spontaneous closure rates have been observed to range from 56 to 82 per cent. 6,7 Studies comparing outcomes after observation only versus different active surgical interventions using various techniques have shown spontaneous closure rates between 53 and 86 per cent in the observation only groups, 8 and closure rates between 88 and 100 per cent in the operated groups.…”

Section: Introductionmentioning

confidence: 99%

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Spontaneous closure of traumatic tympanic membrane perforations: observational study

2015

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Background: The treatment of traumatic tympanic membrane perforations varies in different investigations, ranging from observation to early surgical repair. The present study aimed to focus on the closure rate and the closure time in a group of patients treated with a watchful waiting policy.Methods: The study comprised 133 consecutive patients with a total of 137 perforations. Data were evaluated in terms of aetiology, location and size of perforation, audiometric findings, closure rate, and closure time.Results: The overall closure rate was 97 per cent. For patients with a known closure time within three months, the median closure time was between three and four weeks. The probability of spontaneous closure over time was further analysed with Kaplan-Meier plots, for those perforations with known closure times and for all perforations including those with unknown closure times. Perforation size was the only significant determining factor for closure time.Conclusion: Small perforations had a high probability of spontaneous closure within three to four weeks, justifying a watchful waiting policy. Larger uncomplicated perforations might warrant early surgical repair, depending on the patient's needs and the availability of surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Spontaneous closure of traumatic tympanic membrane perforations: observational study

2015

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“…[16,17] In several studies, it has been found that most traumatic TMPs have a tendency to heal spontaneously with similar rates. [18][19][20][21][22][23] Traumatic TMP frequently occurs in healthy members of the community, generally has excellent prognosis, and if the perforation does not close spontaneously by 3-6 months (in the absence of secondary infection), surgical closure should be considered. [16,17] In our cases, both patients had pruritus in their ears and the traumatic TMPs resulted from self-inf licted negative pressure on the EAC.…”

Section: Discussionmentioning

confidence: 99%

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

Sarıkaya¹

2016

KBB Uygulamaları

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ÖZKulak zarı (KZ) sesi algılayıp yükselterek beyne bilgi aktarır. Kulak zarı delinmesi kesici veya künt travmalar dahil olmak üzere ani basınç değişiklikleri, aşırı akustik enerji değişimleri veya orta kulak iltihabı gibi çeşitli nedenlerden dolayı KZ'nin bütünlüğünün kaybı anlamına gelir ve parmak ile dış kulak yolundan KZ'ye uygulanan negatif basıncın bir sonucu olabilir. Bu yazıda kendi kendine travmatik KZ delinmesi olan iki hasta sunuldu ve literatür ışığında bu nadir tablonun tedavisi tartışıldı.Anahtar sözcükler: Dijital travma; perforasyon; kendi kendine; kulak zarı. ABSTR ACTTympanic membrane (TM) perceives and amplifies sound, and transmits the information to the brain. Tympanic membrane perforation means loss of TM's integrity due to various reasons including penetrating or blunt traumas, sudden changes in pressure, excessive acoustic energy changes or otitis media and it may result from application of negative pressure to TM through external ear canal with fingers. Herein, we present two patients with self-inflicted traumatic TM perforations and discuss management of this rare entity in the light of literature.Keywords: Digital trauma; perforation; self-inflicted; tympanic membrane. © 2016 Official Journal of ENT-HNS Society of IstanbulThe tympanic membrane (TM) is located between the external and the middle ear. It receives and amplifies sound waves, and transmits vibrations to the ossicular chain. Since it is a thin sheet, the TM is relatively sensitive to air pressure changes in the external auditory canal (EAC). Tympanic membrane perforation (TMP) is a loss of TM integrity due to various reasons including penetrating or blunt traumas, sudden changes in pressure, excessive acoustic energy changes or otitis media.[1] The incidence of TMP in the general population is unknown. Tympanic membrane perforation may result from finger-manipulation pressure transmitted to the TM through the external ear canal. Patients with traumatic TMP usually present with hearing loss, bleeding, cerebrospinal f luid (CSF) leak, vertigo, tinnitus, infection, and otalgia. With written informed consent, we present two patients with self-inf licted traumatic TMP and discuss our management of this rare entity in the light of the literature. CASE REPORTCase 1-A 48-year-old male with a history of frequent ear itching presented to our clinic with complaints of left earache, tinnitus, hearing loss, and vertigo after scratching the left ear with his index finger. Otoscopic examination showed that both external ear canals had eczematous otitis and a 4x4 mm, regular bordered, anteroinferiorly located central perforation of the left TM with hyperemia and subepithelial hemorrhage at the

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Paper Patching Versus Watchful Waiting of Traumatic Tympanic Membrane Perforations: A Meta‐Analysis

et al. 2021

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Objectives/Hypothesis The aim of the study was to investigate the healing rates, the restoration of hearing, and the time for complete healing of paper patching versus watchful waiting for traumatic tympanic membrane perforations (TTMPs). Study Design Systematic review with meta analysis. Methods Publications were selected by a search on “PubMed,” “Embase,” and “Web of Science.” A meta‐analysis of risk ratios for paper patching (intervention arm) and watchful waiting (control arm) was performed. Results Five studies describing 393 TTMPs were included in the quantitative meta‐analysis. TTMP healing rates ranged between 84.2% and 95.2% in the intervention arm and between 76.7% and 84.8% in the control arm. The pooled risk ratio of healed TTMPs was significantly higher in the intervention arm than in the control arm (risk ratio: 1.12, 95% confidence interval: 1.04–1.21). Conclusions TTMPs have high healing potential with and without intervention. The healing rate of paper patching was superior to that of watchful waiting alone. Level of Evidence NA Laryngoscope, 131:2091–2097, 2021

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Traumatic tympanic membrane perforations: a study of etiology and factors affecting outcome

Cited by 77 publications

References 18 publications

Spontaneous closure of traumatic tympanic membrane perforations: observational study

Spontaneous closure of traumatic tympanic membrane perforations: observational study

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

Paper Patching Versus Watchful Waiting of Traumatic Tympanic Membrane Perforations: A Meta‐Analysis

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