Traumatic Tympanic Membrane Perforation in Tertiary Health Institution

Background: Traumatic tympanic membrane perforation is a common otologic disorder with associated hearing impairment. Objective: This study aimed at determining the clinico-epidemiological pattern, etiological factors, clinical presentation and management of traumatic tympanic membrane perforation in a Tertiary institution in Nigeria. Materials and Methods: This was a prospective hospital based study of patients with history of traumatic perforated of tympanic membrane. The study was carried out over a period of 5 years (September 2012 to August 2017). A study proforma was used to obtain detailed history and clinical findings from consenting patients. Data collected were collated and analyzed using SPSS version 16.0. Results: Prevalence of traumatic tympanic membrane perforation in this study was 2.1%. There were 65.5% males and 34.5% females with a male to female ratio of 2:1. The common presenting symptoms among the patients were hearing impairment in 68.3%, otalgia in 62.7% and tinnitus in 61.3%. Slap on the ear was the commonest cause of traumatic tympanic membrane perforation in 43.7% of the patients followed by self-ear cleaning in 16.9%. Commonest causes of slap in this study were 15.5% from security agent, 12.7% from seniors/boss while 9.9 % are from spouses. Unilateral traumatic perforation was more common in 97.9% than bilateral in 2.1%. The left ear traumatic perforation was more common than right ear tympanic perforation as 53.5% and 44.4% respectively. Grade 2 in 39.4% was the commonest perforation. Majority of the traumatic perforation were 40.8% central and 33.8% anterior central. Commonest comorbid injuries were subconjunctival hemorrhage in 16.2% and fracture temporal bone in 13.8%. Conductive hearing impairment in 69.7% and sensorineural hearing impairment in 17.6% were the commonest type of hearing impairment in our patients. Commonest degrees of hearing impairment were mild and moderate which accounted for 47.9% and 26.8% respectively. Commonest complications of traumatic tympanic membrane perforation were 68.3% hearing impairment and 26.1% tinnitus. Majority (73.9%) of the patients had conservative/medical therapy and 74.6% traumatic perforation healed at the end of 3 months. Conclusion: Traumatic perforation arises mainly from direct injuries in this study. The patients tend to present with hearing loss and unilateral involvement is the most common. There is the need to educate the public on the dangers of intentional trauma to the ear.