Blast Injuries of the Ears

Spontaneous healing of traumatic tympanic membrane perforations in man: A century of experience

“…Overall, the average rate of spontaneous healing of blast-induced tympanic ruptures in these five series was 47.7 per cent. The post-traumatic observation periods of the casualties reported, however, varied and were often less than one week due to evacuation, as also reported by others (Chavanne, 1920;Colledge, 1921;Stinson, 1936;1941;Craig, 1940;Alexander, 1943;Silcox and Schenck, 1944;Henry, 1945;Folbre, 1947;Friedman, 1948;Baron, 1948;Rice, 1949;Jordan, 1952;Singh and Ahluwalia, 1968).…”

“…Traumatic perforations of the TM have been the subject of a large number of studies published during the last century, but observation periods and spontaneous closure rates of directly induced, uncomplicated traumatic TM defects can be deduced from only a limited number of these. Either this information is lacking or the therapeutic measures have been both passive (expectant observation) and active (early or delayed surgical repair) in the same patients (Chavanne, 1920;Colledge, 1921;Stinson, 1941;Alexander, 1943;Silcox and Schenck, 1944;Henry, 1945;Folbre, 1947;Friedman, 1948;Baron, 1948;Rice, 1949;Jordan, 1952;Kanimturk, 1979;Strohm, 1986;Kronenberg et al, 1988), thus precluding a thorough evaluation of the spontaneous healing rate in these series.…”

“…A great diversity exists regarding the philosophy of treating traumatic TM perforations and associated injuries. Currently, the therapeutic spectrum ranges from expectant observation exclusively (Palmer, 1943;Henry, 1945;Korkis, 1946;Hugh, 1946;Friedman, 1948;Singh and Ahluwalia, 1968;DeWeese and Saunders, 1973;Kerr and Byrne, 1975;Mawson and Ludman, 1979;Lindeman, 1979;Pahor, 1981;Rybak and Johnson, 1983;Kerr and Smyth, 1987) to immediate surgical repair in all cases (Folbre, 1947;Oppenheimer et al, 1961;Armstrong, Accepted for publication: 12 July 1992; Ruggles and Votypka, 1973;Silverstein et al, 1973;Juers, 1974;Sudderth, 1974;Gapanavicius et al, 1977;Merwin and Boies, 1980;Camnitz and Bost, 1985). Although much has been published on the subject since Gruber in 1870, after the Battle of Sadowa in 1866, recorded the first otoscopically visualized, blast-induced perforation of the TM (Craig, 1940) there are still insufficient data available in the literature to guide the otologist in selecting the best treatment procedure (Griffin, 1979;Merwin and Boies, 1980;Camnitz and Bost, 1985;Lindeman etal, 1987;Kristensen et al, 1989).…”

Role of nasal decongestants in spontaneous healing of traumatic tympanic membrane perforation

“…Most of the studies on TM perforation have reported a prevalence of small sized perforation as in our series. 14,15,17,18 The most common quadrant to be involved was postero-inferior quadrant (48.3%) followed by central quadrant (31%). Sarojammaet al 19 also report higher involvement of the posteroinferior quadrant whereas Korkis et al 20 believed that antero-inferior quadrants were affected more in cases of traumatic TM perforation.…”

“…Other workers in traumatic tympanic membrane perforation have also reported decreased hearing and tinnitus as the two major findings. 15,17 Spontaneous healing of traumatic TM perforation is affected by presence of persistent ET dysfunction, exposure of the middle ear cavity to water and chronic infections, as they retard the healing process of the tympanic membrane. 2 Thus it is imperative to avoid exposing the involved ear to water by using petroleum jelly coated cotton while taking bath and avoid swimming till the TM is healed to prevent infections.…”