Traumatic tympanic membrane perforation: an overview in a tertiary care centre-Khammam
Keywords:Traumatic tympanic membrane perforation, Reduced hearing, Spontaneous healing, Outcome
Background: Aim of the study was to distinguish traumatic tympanic membrane perforation (TTMP) by distribution, etiology and clinical presentation and to assess the prognosis and outcome of treatment and establish masterly inactivity as main treatment modality.
Methods: A prospective observational study was performed on 60 cases of traumatic tympanic membrane perforation in the outpatient department of otorhinolaryngology, Mamatha medical college and general hospital, Khammam from October 2019 to March 2021. All the patients came to ENT OPD with the history of trauma to the ear and hearing loss were examined and after obtaining proper history, all the patients underwent ENT clinical examination, oto-endoscopic and audiological evaluation by pure tone audiometry. All the patients diagnosed with traumatic tympanic membrane perforation after obtaining informed written consent were included in the study. All the patients were followed at regular intervals and observations were recorded.
Results: All patients were evaluated based on oto-endoscopic examination. Age ranges from 20-50 years, mean age of 33.6 years and with a male to female ratio of 1:1.4. Commonest etiology was physical assault (61.66%) followed by self-inflicted injury accounting 20%. Tinnitus (90%) was the common presenting complaint and the perforation spontaneously healing is about 90% patients.
Conclusions: Traumatic perforation of tympanic membrane is under-reported otologic defect which has a good prognosis if treated at right time with a need to educate people on the consequences and about unskilled removal of wax/foreign body, early identification and apt diagnosis and management.
Culvert L, Turkington, Carol. Perforated Eardrum. Gale Encyclopaedia of Children's Health: Infancy through Adolescence. 2006.
Schwaber Mitchell K. Trauma to the Middle Ear, Inner Ear, and Temporal Bone. In Ballenger's Otorhinolaryngology Head and Neck Surgery Volume 14. Sixteenth edition. Edited by: James B Snow Jr, John Jacob Ballenger. DC Becker Inc. 2003;345-56.
Da Lilly-Tariah OB, Somefun AO. Traumatic perforation of the tympanic membrane in University of Port Harcourt Teaching Hospital, Port Harcourt. Nigeria., Niger Postgrad Med J. 2007;14(2):121-4.
Conoyer JM, Kaylie DM, Jackson CG. Otologic surgery following ear trauma. Otolaryngol Head Neck Surg. 2007;137:757-61.
Jellinge ME, Kristensen S, Larsen K. Spontaneous closure of traumatic tympanic membrane perforations: observational study. J Laryngol Otol. 2015;129:950-4.
Lou Z, Yang J, Tang Y, Fu Y. Topical application of epidermal growth factor with no scaffold material on the healing of human traumatic tympanic membrane perforations. Clin Otolaryngol. 2016;41(6):744-9.
Bilge A, Gunes A, Dagli M, Koybasioglu FF, Guvey A. The impact of topical and systemic enoxaparin sodium uses on traumatic tympanic membrane perforation and myringosclerosis. Eur Arch Otorhinolaryngol. 2016;273(10):3035-41.
Güneş A, Mutlu M, Akin İ. The Impact of Systemic and Local Administration of Ascorbic Acid on Traumatic Perforation of Tympanic Membrane and Myringosclerosis. J Int Adv Otol. 2015;11:48-52.
Lee JH, Lee JS, Kim DK, Park CH, Lee HR. Clinical outcomes of silk patch in acute tympanic membrane perforation. Clin Exp Otorhinolaryngol. 2015;8:117-22.
Levin B, Redmond SL, Rajkhowa R, Eikelboom RH, Atlas MD, Marano RJ. Utilising silk fibroin membranes as scaffolds for the growth of tympanic membrane keratinocytes, and application to myringoplasty surgery. J Laryngol Otol. 2013;127(1):S13-20.
Park MK, Kim KH, Lee JD, Lee BD. Repair of large traumatic tympanic membrane perforation with a Steri-Strip’s patch. Otolaryngol Head Neck Surg. 2011;145(4):581-5.
Gacek RR, Gacek M R: Anatomy of the Auditory and Vestibular Systems. In Ballenger's Otorhinolaryngology Head and Neck Surgery Volume 1. Sixteenth edition. Edited by: James B Snow Jr, John Jacob Ballenger. DC Becker Inc, Ontario; 2003:1-5.
Berger G, Finkelstein Y, Harell M. Non-explosive blast injury of the ear. J Laryngol Otol 1994;108:395-8.
Sogebi OA, Oyewole EA, Mabifah TO. Traumatic tympanic membrane perforations: characteristics and factors affecting outcome. Ghana Med J. 2018;52(1):34-40.
Lindeman P, Edström S, Granström G, Jacobsson S, Von Sydow C, Westin T et al. Acute traumatic tympanic membrane perforations. Cover or observe? Arch Otolaryngol Head Neck Surg. 1987;113:1285-7.
Lou ZC, Lou ZH, Zhang QP. Traumatic tympanic membrane perforations: A study of etiology and factors affecting outcome. Am J Otolaryngol 2012;33:549-55.
Ologe FE. Traumatic perforation of tympanic membrane in Ilorin Nigeria. Niger J Surg. 2002;8:9-12.
Orji FT. Non-explosive blast injury of the ear. J Laryngol Otol. 1994;108:395-8.
Toner JG, Kerr AG: Ear Trauma. In Scott-Brown's Otolaryngology. Otology 6th edition. Edited by: Booth JB, Kerr, Advisory AG, Groves J. Butterworths Meinemann, London. 1997.