A Retrospective Study of Traumatic Tympanic Membrane Perforation at the University of Benin Teaching Hospital, Nigeria

Abstract

Aim: Traumatic tympanic membrane perforation has been on the increase in recent times due to increased violent conflicts in our society. It is for this reason that this hospital-based observational retrospective study was undertaken to look at the pattern of this occurrence and to create awareness of its consequences in our society.

Methodology: A 10-year retrospective review was performed on 87 cases of traumatic tympanic membrane perforation in the Department of Otorhinolaryngology, Head and Neck Surgery (ENT/HNS) of the University of Benin Teaching Hospital (UBTH), Benin City Nigeria, from Jan.2003-Dec. 2012. Clinical and demographic data of patients and culprits with regard to age and sex and other clinical information were obtained from patients during the study period.

Results: A total of 87 patients out of 94 enrolled for the study had complete data. There were 57 (65.5%) males and 30(34.5%) females with a male/female ratio of approximately 2:1. The culprits were 75(86.2%) males and 12(13.8%). Females in a ratio of 6.3:1. Age ranged from 1-75years with a mean age of 26.4±12.58years. Perforations were common between age 18-34years 57(65.5%) and were mainly of central perforations 83(95.4%). The mechanism of injury was mainly compression injury 71(81.6%). The latter consisted of conflicts resulting in street fights slaps 50(57.5%),hits 11(12.6%),explosives 3(3.4%) and RTA 7(8.0%). Direct injuries were mainly from foreign bodies 9(10.5%) and cotton tips 7(8.0%). Injuries were mainly unilateral, 51(58.6%) and 32(36.8%) in the left and right ears respectively, and 4(4.6%) were bilateral. Common symptoms were hearing loss 79( 91.9%), pain(otalgia) 77( 88.5%). Outcome was 43(49.7%) spontaneous healing, 32(36.8%) lost to follow-up, and 8(9.4%) had chronic suppurative otitis media( CSOM). Non-violence should be employed in conflict resolution as slaps and fights lead to ear trauma and reduces the quality of life of victims.

Keywords: Trauma, Tympanic membrane ,hearing loss, tinnitus, neomembrane