Outcomes for Conservative Management of Traumatic Tympanic Membrane Perforation

Abstract

Objectives: To investigate the incidence of spontaneous repair of fresh traumatic tympanic membrane (TM) perforation and to elucidate the risk factors which they might impair its healing process. Patients and Methods: A cross-sectional prospective study of patients with acute traumatic TM perforation was conducted in otorhinolaryngologic department of AL-Ramadi Teaching Hospital in AL-Ramadi city/Iraq between May 2009 and May 2011. Detailed data matching the diagnosis of traumatic perforation of the TM were analyzed. Clinical examination, pure tone audiogram and regular follow-up were done for all patients. Results: Seventy-two patients (43-males, 29-females), aged 2–70 years (median = 25) with 75 myringoruptures were studied. Three (4.2%) had bilateral TM perforations, 27 (37.5%) right unilateral and 42 (58.3%) left unilateral. Out of 75 myringoruptures, 63 (84%) heal spontaneously. Spontaneous healing of traumatic TM rupture was better in patients with younger age, small sized perforation, low hearing loss at the initial pure tone audiogram assessment (P<0.05). While other factors: gender of the patient, cause, side and duration of the injury does not affect the healing of TM perforation P>0.05. Conclusions: The overall percentage of spontaneous healing of fresh traumatic TM perforation was 84%. Large sized perforation, old age patient and more hearing loss at the time of presentation were worse prognostic factors for healing of such rupture. Early surgical intervention of traumatic drum rupture is not indicated