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.