[Spontaneous course of traumatic tympanic membrane perforations]
D Heitmann1, B Scheffler2, J Abrams3
1Klinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum Braunschweig, Holwedestraße 16, 38118, Braunschweig, Deutschland.
HNO
|January 16, 2021
Summary
Watchful waiting is effective for most traumatic eardrum perforations, with 95% healing. This approach is suitable with regular ENT follow-up, excluding blast injuries which may require surgery.
Area of Science:
- Otorhinolaryngology
- Trauma Surgery
Background:
- Traumatic eardrum perforation is common in ENT and emergency settings.
- A standardized management strategy is currently lacking.
Purpose of the Study:
- To analyze the outcomes of watchful waiting for traumatic tympanic membrane perforation.
- To evaluate the efficacy of non-surgical management.
Main Methods:
- Retrospective analysis of 272 patients with traumatic tympanic membrane perforation.
- Non-surgical treatment with prospective monitoring; antibiotic use varied.
- Outcome evaluation based on patient files.
Main Results:
- 97% of perforations were Grade I (small).
- Common causes included ear impact, barotrauma, and foreign bodies.
- 95% of patients achieved complete closure under watchful waiting.
Conclusions:
- Watchful waiting is appropriate for traumatic eardrum perforation with ENT follow-up.
- Blast injuries are an exception, potentially requiring surgical intervention due to cholesteatoma risk.
- Active treatment is indicated for blast injuries to explore the middle ear and repair the perforation.
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