Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel-Aviv University, 6 Weizman Street, 6423906, Tel Aviv, Israel.
Eur Arch Otorhinolaryngol. 2022 Sep;279(9):4313-4323. doi: 10.1007/s00405-021-07185-7. Epub 2021 Nov 24.
To date, there is no consensus about the benefits of paper patching over spontaneous healing in the management of isolated acute traumatic tympanic membrane perforations (IATTMP). In this systematic literature review and case series, we compared paper patching of IATTMP to spontaneous healing in terms of healing rate and time to heal.
A systematic literature search of English-language studies published from 1/1975 to 9/2020 was conducted using PubMed via MEDLINE, and 201 studies were identified. Another 346 studies were derived from the references of those articles. Twenty-four studies remained after omitting duplications and articles that did not meet the inclusion criteria.
Demographics, medical history, physical examination, and audiometric results in the selected publications and in a new series of patients treated for IATTMP between 1/2018 and 1/2021 in a single tertiary referral center were retrieved and analyzed.
The literature review yielded 2796 ears of which 466 underwent paper patching (intervention arm). Complete perforation healing was documented in 67-97% of control arm and 92-93% of intervention arm. Our new series included 29 ears of which six underwent paper patching. Complete healing was observed in 83% and 78% in the interventional and control arms, respectively.
Although paper patching and watchful waiting had similar success rates in patients with IATTMP, healing after paper patching was slightly quicker among our patients. Patching is a readily applicable and technically simple office-based intervention that should be preferentially considered for IATTMP.
迄今为止，对于孤立性急性外伤性鼓膜穿孔（IATTMP）的治疗，在纸贴修补与自发愈合方面，尚没有关于其益处的共识。在这项系统的文献回顾和病例系列研究中，我们比较了纸贴修补和自发愈合在愈合率和愈合时间方面的差异。
通过 MEDLINE 利用 PubMed 对 1975 年 1 月至 2020 年 9 月发表的英文研究进行了系统的文献检索，共确定了 201 项研究。从这些文章的参考文献中又衍生出了 346 项研究。在排除重复项和不符合纳入标准的文章后，仍有 24 项研究。
检索入选文献中的患者人口统计学、病史、体格检查和听力结果，以及 2018 年 1 月至 2021 年 1 月在一家三级转诊中心治疗的 IATTMP 新系列患者的相关信息，并进行分析。
文献回顾得到了 2796 只耳朵的数据，其中 466 只耳朵接受了纸贴修补（干预组）。对照组的完全穿孔愈合率为 67%-97%，干预组的完全穿孔愈合率为 92%-93%。我们的新系列包括 29 只耳朵，其中 6 只耳朵接受了纸贴修补。干预组和对照组的完全愈合率分别为 83%和 78%。
尽管纸贴修补和观察等待在 IATTMP 患者中的成功率相似，但我们的患者中纸贴修补后的愈合速度略快。纸贴修补是一种易于实施且技术简单的门诊干预措施，对于 IATTMP 应优先考虑。
