Traumatic Perforation of the Tympanic Membrane: A Review of 80 Cases

J Emerg Med. 2018 Feb;54(2):186-190. doi: 10.1016/j.jemermed.2017.09.018. Epub 2017 Oct 28.


Background: Traumatic perforation of the tympanic membrane (TPTM) is often encountered in primary care or in the emergency department (ED). Several therapeutic interventions have been described, but conservative follow-up until spontaneous complete recovery is the most common choice.

Objective: Our goal was to analyze the trauma mechanism, perforation characteristics, and outcome of patients with TPTM.

Methods: The study included patients examined in the ED of a tertiary, university-affiliated medical center because of TPTM between 2012 and 2016. Their medical records were retrospectively reviewed for demographics, trauma mechanism, clinical characteristics, and outcome. A phone survey was performed to obtain the missing information of all the patients who did not continue their follow-up in our outpatient clinic.

Results: We reviewed the histories of 80 patients with a mean age of 26.7 ± 14.6 years (20 children; 25%). TPTM was caused by blunt trauma in 45 patients (56%) and penetrating trauma in 35 patients (44%). Thirty-five patients (44%) completed their follow-up in the hospital outpatient clinic, with a mean duration of 6.2 weeks. Twenty-five patients (38%) completed their follow-up in a community-based otolaryngology clinic, 6 patients (9%) chose not to complete their follow-up, and 14 patients were lost to follow-up. Of the 60 patients who completed follow-up, 56 patients recovered spontaneously, 3 patients underwent successful tympanoplasty, and 1 patient was referred to surgery but was lost to follow-up. All children healed spontaneously.

Conclusion: TPTM was more common in young males with main mechanisms of blunt trauma (an assault) or cleaning the ear canal. All children demonstrated complete spontaneous recovery.

Keywords: Q-Tip injury; myringoplasty; perforation; tympanic membrane; tympanoplasty.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Conservative Treatment / methods
  • Emergency Service, Hospital / organization & administration
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome
  • Tympanic Membrane / injuries
  • Tympanic Membrane Perforation / etiology*
  • Wounds and Injuries / complications