• J Emerg Med · Feb 2018

    Review

    Traumatic Perforation of the Tympanic Membrane: A Review of 80 Cases.

    • Doron Sagiv, Lela Migirov, Eran Glikson, Jobran Mansour, Ruth Yousovich, Michael Wolf, and Yisgav Shapira.
    • Department of Otolaryngology Head and Neck Surgery, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
    • J Emerg Med. 2018 Feb 1; 54 (2): 186-190.

    BackgroundTraumatic perforation of the tympanic membrane (TPTM) is often encountered in primary care or in the emergency department (ED). Several therapeutic interventions have been described, but conservative follow-up until spontaneous complete recovery is the most common choice.ObjectiveOur goal was to analyze the trauma mechanism, perforation characteristics, and outcome of patients with TPTM.MethodsThe study included patients examined in the ED of a tertiary, university-affiliated medical center because of TPTM between 2012 and 2016. Their medical records were retrospectively reviewed for demographics, trauma mechanism, clinical characteristics, and outcome. A phone survey was performed to obtain the missing information of all the patients who did not continue their follow-up in our outpatient clinic.ResultsWe reviewed the histories of 80 patients with a mean age of 26.7 ± 14.6 years (20 children; 25%). TPTM was caused by blunt trauma in 45 patients (56%) and penetrating trauma in 35 patients (44%). Thirty-five patients (44%) completed their follow-up in the hospital outpatient clinic, with a mean duration of 6.2 weeks. Twenty-five patients (38%) completed their follow-up in a community-based otolaryngology clinic, 6 patients (9%) chose not to complete their follow-up, and 14 patients were lost to follow-up. Of the 60 patients who completed follow-up, 56 patients recovered spontaneously, 3 patients underwent successful tympanoplasty, and 1 patient was referred to surgery but was lost to follow-up. All children healed spontaneously.ConclusionTPTM was more common in young males with main mechanisms of blunt trauma (an assault) or cleaning the ear canal. All children demonstrated complete spontaneous recovery.Copyright © 2017 Elsevier Inc. All rights reserved.

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