Modern combined approach to the surgical treatment of patients with post-traumatic tympanic membrane perforation due to blast injuries and eustachian tube dysfunction.

OBJECTIVE

Aim: To improve the effectiveness of surgical treatment for patients with post-traumatic tympanic membrane perforations and concurrent Eustachian tube dysfunction through simultaneous combined surgical methods.

PATIENTS AND

METHODS

Materials and

Methods

We analyzed clinical and functional outcomes of 35 patients (mean age: 34 ± 10,5 years) with tympanic membrane perforations caused by acoustic and blast injuries. The patients were divided into two groups: the first group (n=17) underwent only tympanoplasty type 1, while the second group (n=18) underwent simultaneous septoplasty, inferior turbinectomy, and tympanoplasty with prolonged middle ear ventilation using a subanular Silverstein tube. Parameters analyzed included time from injury to surgery, perforation size and localization, and audiometric results.

RESULTS

Results

Both groups demonstrated significant hearing improvement, with a reduction in the air-bone gap. The results demonstrate the clinical and functional effectiveness of both simultaneous combined surgical treatment (septoplasty, inferior turbinectomy, and tympanoplasty) and isolated tympanoplasty in military patients with tympanic membrane perforations due to blast wave trauma, acoustic barotrauma, and explosion injuries. After treatment, the findings show significantly reduced bone-air gaps and improved air-conducted sound perception thresholds.

CONCLUSION

Conclusions

Simultaneous septoplasty, inferior turbinectomy, and tympanoplasty offer a modern and effective approach to treating patients with post-traumatic tympanic membrane perforations and Eustachian tube dysfunction. Early intervention is particularly critical for military patients exposed to blast injuries to ensure faster recovery.