Relation between eardrum flap area and healing outcome of traumatic eardrum perforation

Objective:To retrospectively study the clinical effects of eardrum flap area on the healing outcome following traumatic perforation. Methods:Totally 291 traumatic eardrum perforations with in-/everted edges were included in this study.They were randomly divided into three groups and received conservative treatment,epidermal growth factor(EGF) via Gelfoam patching,or edge-approximation plus Gelfoam patching respectively.Patients in each group were further divided into two subgroups according to the eardrum flap area≤1/2 or>1/2 of the perforation size.The healing rate and mean closure time after tympanic membrane perforation were evaluated at three months. Results:Of the total 291 participants,281 were included in the final statistical analysis.The area of curled edge did not affect the healing outcome significantly in any groups(P>0.05).The healing rate varied slightly:90.7%vs 92.3%in spontaneous healing group,98.2%vs 97.4%in EGF via Gelfoam patching group,and 96.5%vs 100%in edge-approximation plus Gelfoam patching group.In addition,in all groups the area of curled edge did not affect the mean closure time significantly(P>0.05).The closure time was(32.3±2.4) d vs(30.6±3.1) d in sponaneous healing group,(13.4±2.5)dvs(13.l±1.9)d in EGF via Gelfoam patching group,and(11.9±3.1) d vs(12.2±2.1) d in edge-approximation plus Gelfoam patching group. Conclusion:The eardrum flap area of traumatic eardrum perforation does not significantly affect the clinical outcomes.