Case study of a hydrostatic pressure-induced traumatic chronic tympanic membrane perforation with purulent otorrhea and spontaneous closure

Authors

  • Gavin T. Kress Department of Surgery, University of Southern California Keck School of Medicine, Los Angeles, California, United States of America; Department of Research, B.E.S.T. Engineering, Knoxville, Tennessee, United States of America http://orcid.org/0000-0001-5152-1170
  • Tyler A. Kress Department of Research, B.E.S.T. Engineering, Knoxville, Tennessee, United States of America http://orcid.org/0000-0003-1067-7501

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20222168

Keywords:

Tympanic membrane perforation, Otorrhea, Grade 3, Spontaneous closure, Traumatic, Myringoplasty

Abstract

Tympanic membrane (TM) perforations are ruptures of the membrane separating the middle and outer ear which heal spontaneously in 78.7-94% of cases. However, with large perforations and infection, the spontaneous closure rate diminishes.Chronic TM perforations are thought to rarely close spontaneously and are often treated with a myringoplasty which has a variable success rate, potential risks, and a significant recovery period during which patient activity is notably limited. Significant controversy exists over the indication for surgical intervention in the case of grade 3, chronic TM perforation with a history of infection. The aim of this case study is to provide insight into the typical progression and potential spontaneous resolution of such cases. Moreover, there is a lack of publicly available reference images outlining the progress of TM perforation healing, so detailed time-stamped photos are included. The investigators imaged, at regular intervals, a 23-year-old male’s mid-anterior chronic grade 3 TM perforation who presented with an outer and middle ear infection with purulent otorrhea. The result indicates that chronic grade 3 TM perforations with a history of infection still have potential to spontaneously close. Given the risks and inconvenience of a myringoplasty, further consideration should be taken before recommending this procedure in these cases.

Metrics

Metrics Loading ...

References

Dolhi N, Weimer A. Tympanic Membrane Perforations. StatPearls Publishing. 2021.

Wahid F, Nagra S. Incidence and characteristics of Traumatic Tympanic Membrane perforation. Pak J Med Sci. 2018;1099.

Orji FT, Agu CC. Determinants of spontaneous healing in traumatic perforations of the tympanic membrane. Clin Otolaryngol. 2008;33(5):420-6.

Kristensen S. Spontaneous healing of traumatic tympanic membrane perforations in man: a century of experience. J Laryngol Otol. 1992;106(12):1037-50.

Seonwoo H, Kim SW, Kim J, Chunjie T, Lim KT, Kim YJ, Pandey S, Choung PH, Choung YH, Chung JH. Regeneration of chronic tympanic membrane perforation using an EGF-releasing chitosan patch. Tissue Eng Part A. 2013;19(17-18):2097-107.

Darouassi Y, Aljalil A, Ennouali A, Hanine M, Chebraoui Y, Bouaity B, et al. Prognostic factors of myringoplasty: study of a 140 cases series and review of the literature. Pan Afr Med J. 2019;1937-8688.

Cho G, Moon C, Song A, Vijayakumar K, Ang M, Jang C. Effect of Growth Factor-Loaded Acellular Dermal Matrix/MSCs on Regeneration of Chronic Tympanic Membrane Perforations in Rats. J Cli Med. 2021;1541.

Lou Z, Wang Y. Evaluation of the optimum time for direct application of fibroblast growth factor to human traumatic tympanic membrane perforations. Growth Factors. 2015;65-70.

Huang P, Zhang S, Gong X, Wang X, Lou Z. Endoscopic observation of different repair patterns in human traumatic tympanic membrane perforations. Braz J Otorhinolaryngol. 2018;545-52.

Downloads

Published

2022-08-25

Issue

Section

Case Reports