Traumatic Tympanic Membrane Perforation in Lokoja, Nigeria: A Review of 43 Cases

Abstract Background: The tympanic membrane main function is the conduction of sound waves for effective hearing hence its perforation almost always results in initial hearing impairment of a reasonable degree. Objectives: To identify common causes, clinical presentation and management outcome of a perforated tympanic membrane. Methods: This is a three year (January 2013-December 2015) prospective hospital base study carried out in the ENT Outpatient clinic of the Federal Medical Centre, Lokoja, Nigeria. Patients were recruited by convenience sampling method after a clinical diagnosis of traumatic tympanic membrane perforation. All patients were made to have PTA for their hearing assessment during and after treatment. Results: A total of 49 patients were recruited but 6 were lost to follow up, the remaining 43 were 24 males and 19 females with a male to female ratio of 1.26:1. Age range was from 2-80years and the modal age group was 11-20years. Ear cleaning and scratching with pointed objects was the commonest cause of traumatic tympanic membrane perforation followed by slapping from assault. Pain was the most common symptom at presentation followed by hearing loss. Spontaneous healing of the membrane occurred in 6 weeks in 34.9% of the patients and with complete restoration of hearing in 96%.

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Outcome of Myringoplasty in Underlay Technique

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v24i2.44173 ◽

2019 ◽

Vol 24 (2) ◽

pp. 131-136

Author(s):

Md Abdur Razzak ◽

KM Mamun Murshed ◽

AKMA Sobhan ◽

Md Rakib Hossain ◽

SM Nafeez Imtiaz

Keyword(s):

Success Rate ◽

Tympanic Membrane ◽

Surgical Techniques ◽

Neck Surgery ◽

Tympanic Membrane Perforation ◽

College Hospital ◽

Medical College ◽

Tympanic Membrane Perforations ◽

Membrane Perforation ◽

Age Range

Background: Myringoplasty is one of the surgical techniques for the management of chronic supportive otitis media with permanent perforation of tympanic membrane. It is defined as simple surgical repair of tympanic membrane perforation without doing ossicular reconstruction. Objective: To determine the success rate of myringoplasty and to examine whether the hearing improvement is a potential indication for surgery. Methods: This study was conducted in the Department of Otorhinolaryngology and Head and Neck Surgery, Shaheed Suhrawardy Medical College Hospital from January 2017 to December 2017 and 100 patients who underwent myringoplasty in this period were analyzed. About 100 patients with dry central tympanic membrane perforations of various size were included in this study Results: Myringoplasty was performed in 100 patients. Male were (45%) and females were (55%).Twenty one (7%) of them belonged to age group of 10-20 years, 31 (31%) were in the age range of 21-33 years, 38(38%) were the age range 31-40 years while 24 (24%) aged between 41-50 years with mean age of 26.32 ±S.D 9.59 years. Overall success rate of graft uptake was noted in 88 (88%) out of 100 cases Conclusion: Myringoplasty is a safe surgical procedure in achieving intact tympanic membrane and to improve the hearing loss. Therefore, underlay technique being technically simple should be preferred, but the ultimate decision about the technique to be employed depends on the surgeons preference and the site of perforation Bangladesh J of Otorhinolaryngology; October 2018; 24(2): 131-136

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Traumatic tympanic membrane perforation: an overview in a tertiary care centre-Khammam

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20212786 ◽

2021 ◽

Author(s):

Agni Vishnu Sailesh ◽

Vivek Arumugham ◽

Siva Subba Rao Pakanati ◽

Shilpa Potnuru

Keyword(s):

Tympanic Membrane ◽

Tertiary Care ◽

Pure Tone Audiometry ◽

Good Prognosis ◽

Endoscopic Examination ◽

Tympanic Membrane Perforation ◽

Physical Assault ◽

Tertiary Care Centre ◽

Female Ratio ◽

Membrane Perforation

Background: Aim of the study was to distinguish traumatic tympanic membrane perforation (TTMP) by distribution, etiology and clinical presentation and to assess the prognosis and outcome of treatment and establish masterly inactivity as main treatment modality.Methods: A prospective observational study was performed on 60 cases of traumatic tympanic membrane perforation in the outpatient department of otorhinolaryngology, Mamatha medical college and general hospital, Khammam from October 2019 to March 2021. All the patients came to ENT OPD with the history of trauma to the ear and hearing loss were examined and after obtaining proper history, all the patients underwent ENT clinical examination, oto-endoscopic and audiological evaluation by pure tone audiometry. All the patients diagnosed with traumatic tympanic membrane perforation after obtaining informed written consent were included in the study. All the patients were followed at regular intervals and observations were recorded.Results: All patients were evaluated based on oto-endoscopic examination. Age ranges from 20-50 years, mean age of 33.6 years and with a male to female ratio of 1:1.4. Commonest etiology was physical assault (61.66%) followed by self-inflicted injury accounting 20%. Tinnitus (90%) was the common presenting complaint and the perforation spontaneously healing is about 90% patients.Conclusions: Traumatic perforation of tympanic membrane is under-reported otologic defect which has a good prognosis if treated at right time with a need to educate people on the consequences and about unskilled removal of wax/foreign body, early identification and apt diagnosis and management.

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Evaluasi Pendengaran Pasien Pascatindakan Miringoplasti Berdasarkan Gambaran Audiometri Nada Murni di Rumah Sakit Dr. Hasan Sadikin Bandung

Journal Of Medicine & Health ◽

10.28932/jmh.v3i1.3171 ◽

2021 ◽

Vol 3 (1) ◽

pp. 9-15

Author(s):

Anggie Mutmainnah ◽

Arif Dermawan ◽

Lina Lasminingrum

Keyword(s):

Tympanic Membrane ◽

Middle Ear ◽

Hearing Threshold ◽

Pure Tone Audiometry ◽

Descriptive Study ◽

Tympanic Membrane Perforation ◽

Hearing Improvement ◽

Membrane Perforation ◽

Ear Infections ◽

Age Range

Tympanic membrane perforation is one of the causes of hearing loss and can causerecurrent middle ear infections. Myringoplasty is a procedure for reconstruction of the tympanicmembrane perforation by using a ring in the ear with a complete hearing bone chain, goodmotion, and no pathological tissue in the middle ear. Myringoplasty aims to improve hearingfunction and prevent recurrent infections of the middle ear and inner ear. This study aimed tofind out the hearing characteristics of patients after myringoplasty based on an image of pure tone audiometry in the THT-KL Poli RSHS Bandung period January - December 2016. This is aretrospective descriptive study of patients undergoing myringoplasty. There were 285 new casesof tympanic membrane perforation with an age range of 15-55 years; 153 men (53.7%), 132women (46.3%), 109 (50.27%) patients had an increase in the hearing threshold of 10.1 dB - 20dB, reaching a normal hearing threshold of 249 (87, 4%) patients, and closure of perforationwere 254 (89.1%) patients. In a conclusion, there was a good hearing improvement aftermyringoplasty on tympanic membrane perforation without other abnormalities. Keywords: Myringoplasty, perforation of the tympanic membrane, increased hearing threshold.

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Otorhinolaryngological Trauma in Some Private Health Facilities in Benin City

Journal of Complementary and Alternative Medical Research ◽

10.9734/jocamr/2021/v13i130216 ◽

2021 ◽

pp. 20-28

Author(s):

I. O. Akpalaba ◽

F. O. Ogisi ◽

R. O. Momoh

Keyword(s):

Tympanic Membrane ◽

Hospital Setting ◽

Tympanic Membrane Perforation ◽

Cost Of Care ◽

Treatment Modalities ◽

Suppurative Otitis Media ◽

Early Presentation ◽

Female Ratio ◽

Benin City ◽

Membrane Perforation

Background: Otorhinolaryngological trauma is common in clinical practice. The disaster caused by otorhinolaryngological trauma arises from its morbidity and mortality. This is due to increased cost of care and varying degree of physical, cosmetic and functional disfigurements. Aim: This study was conducted to determine the causes, mechanisms of trauma and outcomes of these injuries in private setting; and to profer possible preventive measures. Methods: This study was a one-year descriptive prospective study on patients with otorhinolaryngological trauma managed at three private health settings in Benin City, Nigeria. All consecutive trauma patients seen from May 2016 to April 2017 constituted the sample size. Total population sampling technique was used. Statistical analysis was performed using SPSS version 20.0. Results: A total of 31 patients were studied. Age ranged from 1 to 80 years. Median age was 35 years. Male to female ratio was 1.1:1. The commonest cause of trauma was use of cotton buds to clean the ears in 48.4% patients. This was followed by foreign bodies in the ear in 12.9% of the patients. This was not statistically significant as p>0.05. The commonest mechanism of trauma was from Tympanic membrane perforation, canal laceration and ear canal inflammation in 48.4% of patients. The ear was the most affected region in 80.6% of the patients. The greatest complain at presentation was ear discharge in 38.7% of the patients, followed by hearing loss in 35.5% patients. The commonest complication was tympanic membrane perforation noted in 48.4% of the study population followed by chronic suppurative otitis media in 35.5% of them. Majority of the subjects (87.1%) were treated as outpatients. Only 12.9% of the subjects required admission to the ward. The most common treatment modalities used were ‘keeping the ear dry’ protocol, ear toileting and daily ear dressing in 80.6%, 41.9% and 38.7% of the patients respectively. The median length of hospital stay for in-patients was 7 days (range 3 to 11 days). There was no mortality. Majority of the patients (77.4%) had full recovery. Tympanic membrane perforation was persistent in 22.6% of the patients. Conclusion: Otorhinolaryngological trauma constitutes a significant cause of morbidity in private hospital setting. Majority of these trauma are both preventable and treatable through public enlightenment programmes and early presentation to Otorhinolaryngologists respectively.

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Outcome of conchal cartilage shield type I tympanoplasty: a prospective study of 70 patients

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20190770 ◽

2019 ◽

Vol 5 (2) ◽

pp. 408

Author(s):

Ayisha Kunnumal ◽

G. Priyadarshini

Keyword(s):

Tympanic Membrane ◽

Chronic Otitis Media ◽

Tympanic Membrane Perforation ◽

Type I ◽

Female Ratio ◽

Conchal Cartilage ◽

Medical College ◽

Uptake Rates ◽

Membrane Perforation ◽

A Prospective Study

Background: Tympanoplasty is a surgical procedure performed to reconstruct hearing mechanism with or without reconstruction of tympanic membrane perforation. Cartilage shield tympanoplasty was first reported in literature by Duckert et al in 1995.The purpose of the present study was to prepare the cartilage shield graft and to evaluate its effect on the success rate of tympanoplasty.Methods: In this study 70 patients who presented to ENT OPD of Aarupadai Veedu medical college, Puducherry, with chronic otitis media (COM) mucosal type, who were treated during the period between December 2016 to April 2018 were enrolled. Patients with COM mucosal type, with mild to moderate conductive hearing loss, dry or moist ear were included in the study. Detailed history was taken in the selected patients including a thorough otological examination and blood investigations required for surgery. Results: In the present study male to female ratio was 1.6:1. 30% patients were in the age group between 20-24years. In our study 33% patients had pre-operative airbone gap in the range of 31-40 dB and post-operative improvement in airbone gap was in the range of 0-10 dB in 49% patients.Conclusions: Conchal cartilage shield tympanoplasty is an effective technique in tympanic membrane reconstruction and shows no detrimental effect to the hearing outcome. Conchal cartilage is preferred graft as it can be harvested from same incision. The graft uptake rates are excellent with this technique.

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Aftermath of traumatic tympanic membrane perforation: Our findings at a tertiary care hospital in Pakistan

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.3.3923 ◽

2021 ◽

Vol 37 (3) ◽

Author(s):

Fazali Wahid ◽

Muhammad Saleem ◽

Raza Muhammad ◽

Muhammad Riaz Khan

Keyword(s):

Sample Size ◽

Tympanic Membrane ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Neck Surgery ◽

Tympanic Membrane Perforation ◽

Common Finding ◽

Care Hospital ◽

Female Ratio ◽

Membrane Perforation

Objectives: To determine the outcome of traumatic tympanic membrane perforation in a teaching hospital at Peshawar, Pakistan. Methods: This prospective observational study was performed in the Department of ENT and Head and Neck Surgery, MTI/LRH, Peshawar, Pakistan from January 2016 to December 2019 after approved from Institutional Research and Ethical Board. All consented patients fulfilling inclusion criteria were enrolled. Sample size was calculated 114 using online sample size calculator (OpenEpi). Every patient was evaluated properly, subsequently otoscopy and PTA was performed. Required information was recorded and analyzed using SPSS (version 25). Results: Out of 114 patients 81 (71.1%) were males and 33(28.9%) were female with male: female ratio of 2.5:1. Patient’s age ranged from 6- 55 years with mean ± SD age of 26.41 ± 9.7 years. Majority of Patients, 46.5%( 53) were in 2nd decade. Amongst the causes slap outnumbered (80, 70.2%), and left ear was involved predominately (67, 58.7%) affecting mainly anterio-inferior quadrant (50, 43.9%). Small size perforation was most common finding (64, 56.1%). Majority of patients (72, 63.2%) presented in a week time and single perforation was the commonest (107, 93.%). Most of traumatic TM perforation got healed spontaneously (97, 85.1%). Conclusion: It is concluded that spontaneous healing of traumatic membrane perforation occurs in more than 90% cases provided the ear is kept dry and not accompanied by unfavorable conditions. doi: https://doi.org/10.12669/pjms.37.3.3923 How to cite this:Wahid FI, Saleem M, Muhammad R, Khan MR. Aftermath of traumatic tympanic membrane perforation: Our findings at a tertiary care hospital in Pakistan. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.3923 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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