Late crust formation as a predictor of healing of traumatic, dry, and minor-sized tympanic membrane perforations.

Objective: The goal of this study was to evaluate the effects of crust formation on the healing of traumatic, dry, and minor-sized tympanic membrane perforations (TMPs) in humans.
Study Design: Case series with a chart review.
Setting: Tertiary university hospital.
Materials and Methods: The clinical records of patients with traumatic TMPs who met the case selection criteria were retrieved and categorized according to the presence of a crust and the timing of crust formation into three groups: no crust, early crust formation, and late crust formation. Healing outcomes (i.e., healing rate and time) in the three groups were analyzed.
Results: In total, 83 patients were analyzed. The perforation closure rates were 92%, 100%, and 78% in the groups with no-crust, early crust formation, and late crust formation, respectively. No significant difference was seen between the groups with no-crust and with late crust formation (p>0.05). By contrast, closure rates differed significantly between the early and late crust formation groups (p<0.05). Overall, the no-crust and early crust formation groups showed shorter healing times compared with the late crust formation group (p<0.05). However, closure times did not differ significantly between groups with early crust formation and no crust (p>0.05).
Conclusions: Crust formation at the margin of a traumatic TMP may serve as a predictor of healing outcome. Compared with perforations with early crust formation or no crust, late crust formation can result in delayed healing and failure to close completely.
(Copyright © 2013 Elsevier Inc. All rights reserved.)