Kristensen S
Department of Otorhinolaryngology, St Joseph's Hospital, Esbjerg, Denmark.
J Laryngol Otol. 1992 Dec;106(12):1037-50. doi: 10.1017/s0022215100121723.
Widespread controversy exists concerning the treatment of traumatic tympanic membrane perforations. To elucidate the issue, a reference value for the rate of spontaneous tympanic membrane closure in man, to which the healing rates following different techniques of early surgical repair should be compared, was established on the basis of a review of more than 500 texts covering a century's literature on the traumatically perforated tympanic membrane. The spontaneous healing rate appeared to be close to 80 (78.7 per cent) in 760 evaluable cases of traumatic tympanic membrane perforations of all sorts diagnosed within 14 days post injury. A relative, causal-related variation of spontaneous healing could be demonstrated, and a pathogenetic classification of direct traumatic tympanic membrane perforations into ruptures induced by air-pressure changes, heat or corrosives, solids, and water pressures, is of proved clinical value and may have medico-legal validity. There is an obvious need for clinically controlled studies on the spontaneous healing of all kinds of traumatic perforations of the tympanic membrane in humans, and important elements in the design of future studies are advocated.
关于外伤性鼓膜穿孔的治疗存在广泛争议。为阐明这一问题，在回顾了涵盖一个世纪有关外伤性鼓膜穿孔文献的500多篇文章的基础上，确定了人类鼓膜自发闭合率的参考值，不同早期手术修复技术后的愈合率应与之进行比较。在受伤后14天内诊断出的760例各类可评估的外伤性鼓膜穿孔病例中，自发愈合率似乎接近80%（78.7%）。可以证明自发愈合存在相对的、与病因相关的差异，将直接外伤性鼓膜穿孔根据气压变化、热或腐蚀性物质、固体及水压引起的破裂进行病因分类，已证明具有临床价值，可能也具有法医学效力。显然需要对人类各种外伤性鼓膜穿孔的自发愈合进行临床对照研究，并提倡了未来研究设计中的重要要素。
