Evolving Options and Challenges in the Management of Traumatic Perforation of Tympanic Membrane, Pondicherry India, 2016

Background Damage to the tympanic membrane remains a substantial burden to patients presenting the emergency department . Traumatic perforation of the tympanic membrane though a common injury are mostly under reported. Many perforations are small and heal spontaneously. This study was conducted to analyze the mechanism of injury , treatment outcome of conservative management and when to do surgical management. Methods We conducted cross sectional study among patients presenting with tympanic membrane perforation. Diagnosis was done using otoscopic and otoendoscopic examination. Patients were screened for hearing loss by Pure Tone Audiometry at the time of presentation .All patients were advised follow up every week for a period of 6 weeks. Systemic and local risk factor estimation was done in a comprehensive examination .Univariate and stepwise regression analyses were done to identify the independent risk factors associated with the presence and severity of trauma. We calculated adjusted odds ratio with 95% CI to identify the factors associated with traumatic perforation. Results About 121 cases were recruited for the study The mean age group is 31.5±10 years.. Nearly 65.29 %. of traumatic perforation of tympanic membrane were among females There were 15 cases who presented bilaterally ,thus making it 136 affected ears. The predominant symptomatology were impaired hearing 47.93%, earache19.01% and bleeding from ear 6.61%.In context of conductive hearing loss 60.3% had a range of 26-35dB,The common aetiology for traumatic perforation of tympanic membra Conclusion Ear trauma is common phenomena which mostly commonly affects the tympanic membrane. Sudden increase in canal pressure from blows and slaps were the major mechanism of injury. Management outcome was good except for few late presenters with complications. Persistent conductive hearing loss suggests disruption of the ossicular chain, necessitating surgical exploration and re