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

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.

Chinese abstract

背景：创伤性鼓膜穿孔（TTMP）通常接受保守治疗, 因为大多数都会在几个月内自发闭合。然而, 在长期观察期间TTMP的自发闭合尚未在文献中很好地描述。

目的：本研究调查了与TTMP自发闭合相关的因素, 以及长期观察后显示自发闭合的病例特征。

材料与方法：回顾性分析了就诊于作者所在医院的40例TTMP患者的病历资料。

结果：27例（67.5％）患者发生自发性闭合。愈合期小于两周的有6例, 小于四周的9例, 小于三个月的5例, 小于六个月的3例, 大于并等于六个月的4例。自发性闭合期≥6个月的所有4例均出现伤后6个月自发闭合的征兆。与锤骨接触的穿孔和较低的自发闭合率相关。

结论和意义：对于TTMP, 应考虑为患有与锤骨接触的穿孔的病人进行手术。然而, 还有人提出, 当在受伤后6个月内观察到自发闭合的迹象时, 长期观察可能是一种可行的治疗选择。

Keywords:

• Traumatic tympanic membrane perforation
• spontaneous closure
• long-term observation

Acknowledgement

The authors report no financial interests, relationships and affiliations relevant to the subject of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.