Spontaneous closure of traumatic tympanic membrane perforation following long-term observation

Acta Otolaryngol. 2019 Jun;139(6):487-491. doi: 10.1080/00016489.2019.1592225. Epub 2019 Apr 7.

Abstract

Background: Traumatic tympanic membrane perforation (TTMP) is usually managed conservatively because most close spontaneously within a few months. Nevertheless, spontaneous closure of TTMP during long-term observation has not been well described in the literature.

Objectives: The present study investigated factors associated with spontaneous closure of TTMP, and the characteristics of cases exhibiting spontaneous closure following long-term observation.

Materials and methods: The medical records of 40 patients with TTMP who visited the authors' hospital were retrospectively reviewed.

Results: Spontaneous closure was observed in 27 (67.5%) patients. The healing period was <2 weeks in 6 cases, <4 weeks in 9, <3 months in 5, <6 months in 3, and ≥6 months in 4. All four cases in which spontaneous closure took ≥6 months exhibited a sign of spontaneous closure at 6 months following injury. Perforation in contact with the malleus was associated with a lower frequency of spontaneous closure.

Conclusions and significance: In TTMP, surgery should be considered in patients who exhibit perforation in contact with the malleus. However, it has also been suggested that long-term observation may be a viable treatment option when a sign of spontaneous closure is observed within 6 months following injury.

Keywords: Traumatic tympanic membrane perforation; long-term observation; spontaneous closure.

MeSH terms

  • Adult
  • Age Factors
  • Child
  • Databases, Factual
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Remission, Spontaneous
  • Retrospective Studies
  • Risk Assessment
  • Sex Factors
  • Time Factors
  • Tympanic Membrane / injuries*
  • Tympanic Membrane Perforation / etiology*
  • Tympanic Membrane Perforation / physiopathology*
  • Wound Healing / physiology*
  • Young Adult