Traumatic tympanic membrane perforations: characteristics and factors affecting outcome.

OBJECTIVE

To characterize traumatic tympanic membrane perforation (TTMP) in terms of distribution, mechanisms, and outcome of treatment. To assess the factors influencing such outcome.

STUDY

DESIGN

Prospective analytical study, assessing outcomes post-injuries.

SETTING

Clinical department of a tertiary referral hospital.

PARTICIPANTS

Patients with TTMP based on history of trauma to the ear, and otoscopic examination confirming tympanic membrane (TM) perforation.

INTERVENTIONS: Conservative, inactive treatment.

MAIN OUTCOME MEASURES: Distribution and healing of perforations.

RESULTS

There were 53 patients, Male: Female ratio =1.5:1, age 8-71years (Mean ±SD= 33.8 ±12.9). Median duration of injury before presentation was 3 days. 11 patients had both ears traumatized. 46.9% of perforations were in the antero-inferior part of the TM. Median size of perforations was 33.0%; Patients main complaints were blockage of the ears/ hearing loss and tinnitus. Common causes of perforations were domestic assault (28.3%), self-inflicted/ accidental injuries (20.8%), and road traffic accidents (18.9%). There was a significant difference in the mechanism/cause of injuries between the sexes (X2 =15.607, p=0.005). Traumatic perforation was caused by penetrating injuries in 22 (34.4%) ears. The outcome of TTMP was poor in 18.7%. Big sized perforations (t=2.630; p=0.011), penetrating injuries (X2 =9.263; p=0.005), and postero-superior location (X2=6.326;p=0.009) had negative impacts on the healing.

CONCLUSIONS

TTMP was common in young adult males, caused often by assaults, presented with ear hearing loss and tinnitus, perforations were located in antero-inferior part of TM and most healed well. Factors associated with poor healing were postero-superior location, large size and penetrating injuries to the TM.

FUNDING: Not indicated.