Objective To discuss wound edge characteristics at different clinical periods and in-tervention of traumatic perforation of tympanic membrane. Methods A total of 494 patients wth trau-matic perforation of tympanic membrane were treated and grouped based on treatment time and size of per-foration. Group A (n = 154, within 12 hours after injury) were treated by residual tympanic membrane repair and gelfoam. Group B (n =149, 12 hours after injury) were treated by simple gelfoam. Group C (n = 116) and Group D (n =75) were treated by conventional therapy. The wound healing of peroration was observed after one month. Results Of all, there were 419 patients with maximum perforation diameter > 2.5 mm within five hours after injury, of which 349 patients (83.3%) were with residual tympanic membrane valgus of perforation rim, 29 (6.9%) with involution of perforation rim and 41 (9.8%) with complete loss of tympanic membrane. Of 75 patients with maximum perforation diameter <2.5 ram, residual valgus of perforation rim was found in 18 (24.0%) and tympanic membrane wrinkle near wound edge in the other patients. Under endoscopic repair of crimp tympanic membrane, maximum perforation diameter was reduced for (6.5±2.5)mm in 143 patients at 6th hour, (6.0±1.5)mm in 11at 7-11 hours, (2.0±1.5) mm in 27 at 13-24 hours, (1.5±1.0) mm in 59 at 25.5-48 hours, (1.0±0.5) mm in 49 at 51-73 hours and 0 mm in 14 at 75-192 hours. The follow up lasted for one month, which showed that healing rate of perforation in groups A, B, C and D were 85.3%, 71.2%, 59.2% and 81.4%, respectively. Healing time span was (10±4) days, (19±4) days, (25±2) days and (16±2) days, respectively. Conclusions Traumatic perforation of tympanic membrane is not com-plete tympanal deletion but residual tympanic membrane valgus of perforation rim,involution and tympanicmembrane crushing, which shows insignificant change with time. In time repair of residual tympanic membrane 12 hours(especially 6 hours) after injury may reduce the largest diameter of perforation and re-markably shorten the healing time of perforation.

OBJECTIVE: Evaluation of different repair mechanism and influencing factors for Prognosis of tympanic membrane perforations. METHOD: One hundred and twelve female patients of tympanic membrane perforations were randomly divided into two groups: control group (natural repair group) and treatment group (gelatin sponge patch bonded repair group). The perforation healing were dynamically observed in two groups by endoscope. RESULT: The result show that low, medium and high perforations healing rates were 100.00%, 90.48%, 93.33%. The healing time of low, medium and high was (9.0 +/- 2.8) d, (13.0 +/- 2.6) d, (22.0 +/- 4.7) d, the epithelial layer reverse growth in 5 cases. The result show that low, medium and high perforations healing rates were 91.67%, 95.24%, 84.62%. The healing time of low, medium and high was (11.0 +/- 3.7) d, (24.0 +/- 3.8) d, (36.0 +/- 2.1) d, 2 cases were undergone surgeries. CONCLUSION There are differences in repair mechanism between natural repair and patch bonded repair patch bonded repair can promote granulation hyperplasia, it can help recovering and lessening the patient's conductive hearing loss and occasional tinnitus. granulation hyperplasia and the healing time is closely related. The epithelial layer reverse growth may affect the healing of tympanic membrane perforation.
Adult ; Female ; Humans ; Middle Aged ; Tympanic Membrane Perforation ; etiology ; therapy ; Wound Healing ; Young Adult

The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.