Premium
A randomised controlled trial comparing spontaneous healing, gelfoam patching and edge‐approximation plus gelfoam patching in traumatic tympanic membrane perforation with inverted or everted edges
Author(s) -
Lou Z.C.,
He J.G.
Publication year - 2011
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/j.1749-4486.2011.02319.x
Subject(s) - medicine , tympanic membrane perforation , surgery , perforation , tympanoplasty , punching , materials science , metallurgy
Clin. Otolaryngol. 2011, 36 , 221–226 Objective: To compare the outcome of patients with dry traumatic tympanic membrane perforation after spontaneous healing and gelfoam patching with or without perforation edge approximation. Design: Prospective clinical study. Setting: University‐affiliated teaching hospital. Participants: Ninety‐one patients with acute dry traumatic tympanic membrane perforation inverted or everted edges were recruited. They were randomly allocated to three groups: spontaneous healing ( n = 31), gelfoam patching ( n = 30) and edge‐approximation plus gelfoam patching ( n = 30). Otoscopy and tympanometry were performed before the treatment and at follow‐up visits. Main outcome measures: Healing rate, healing time, ear infection rate and morphological changes during healing process. Results: The overall healing rate was 85% in the spontaneous healing group, lower than that in the two gelfoam patching groups (97%), but the difference failed to reach a statistical significance ( P > 0.05). The average healing time was 30 ± 10.1 days in the spontaneous healing group, significantly longer ( P < 0.01) than that in the other two groups (16 ± 5.6 and 18 ± 4.7 days, respectively). Middle ear infection rate did not differ significantly (7%, 3% and 3%, respectively). Spontaneous healing resulted in formation of scabs at the perforation edges, which was effectively prevented by gelfoam patching. Conclusions: Gelfoam patching may facilitate healing of traumatically perforated tympanic membrane. Approximation of folded perforation edges is not necessary in gelfoam patching.