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Spontaneous healing of traumatic tympanic membrane perforations in man: A century of experience

Published online by Cambridge University Press:  29 June 2007

Søren Kristensen*
Affiliation:
Esbjerg, Denmark
*
Dr Søren Kristensen, M.D., Department of Otorhinolaryngology, St Joseph's Hospital, Nørregade 63, 6700 Esbjerg, Denmark.

Abstract

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.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1992

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References

Alberti, P. W. R. M. (1964) Epithelial migration on the tympanic membrane. Journal of Laryngology and Otology, 78: 808830.CrossRefGoogle ScholarPubMed
Alexander, A. B. (1904) Wartime rupture. British Medical Journal, 11: 195196.Google Scholar
Alexander, G. (1913) Mittelohr verletzung durch Einspritzen glühenden Eisens ins Mittelohr: Gesellschaftsberichte von Österreichische otologische Gesellschaft. Internationales Zentralblatt für Ohrenheilkunde und Rhino-Laryngologie, 11: 190192.Google Scholar
Alexander, A. B. (1943) Blast injuries to the ear. Medical Press and Circular, 209: 249251.Google Scholar
Amiri, C. S. (1977) Hypothesis based on anatomical aberration and certain conditions responsible for cholesteatoma formation. In Cholesteatoma: First International Conference (McCabe, B. E.Sade, J., Abramson, M., eds). Aesculapius Publishing Company,Birmingham, p 204207.Google Scholar
Armstrong, B. W. (1972) Traumatic perforations of the tympanic membrane: Observe or repair. Laryngoscope, 82: 18221830.CrossRefGoogle ScholarPubMed
Ballantyne, J. (1979) Traumatic conductive deafness. In Scott-Brown's Diseases of the Ear, Nose and Throat, Vol. 2, The Ear (Ballantyne, J. J., Groves, J., eds). Butterworths, London, p 159173.Google Scholar
Ballenger, J. J. (1977) Diseases of the Nose, Throat and Ear, Lea & Febiger, Philadelphia.Google Scholar
Baron, S. H. (1948) The repair of the eardrum in blast injuries. Annals of Otology, Rhinology and Laryngology, 57: 143153.CrossRefGoogle ScholarPubMed
Bellucci, R. J. (1983) Traumatic injuries of the middle ear. In The Otolaryngologic Clinics of North America. Vol. 16, Symposium on Trauma to the Head and Neck (Maniglia, A. J., ed.), Saunders Company,Philadelphia, p. 663–650.CrossRefGoogle Scholar
Bergstrom, L. V., Neblett, L. M., Sando, I., Hemenway, W. G., Harrison, G. D. (1974) The lightning damaged ear. Archives of Otolaryngology, 100: 117121.CrossRefGoogle ScholarPubMed
Bettington, R. H. B. (1945) Injuries to the ear due to blast. Medical Journal of Australia, 2: 210211.CrossRefGoogle Scholar
Bezold, E. (1882) Verbrühung des Trommelfells. Archiv für Ohrenheilkunde, 18: 4958.CrossRefGoogle Scholar
Blake, C. J. (1882) The progressive growth of the dermoid coat of the membrana tympani. American Journal of Otology, 4: 266268.Google Scholar
Boedts, D. (1978) The tympanic epithelium in normal and pathological conditions. Acta Oto-Rhino-Laryngologica Belgica, 32: 294419.Google ScholarPubMed
Brookes, G. B. (1983) Post-traumatic cholesteatoma. Clinical Otolaryngology, 8: 3138.CrossRefGoogle ScholarPubMed
Bruins, W. R., Cawood, R. H. (1991) Blast injuries of the ear as a result of the Peterborough lorry explosion: 22 March 1989. Journal of Laryngology and Otology, 105: 890895.CrossRefGoogle ScholarPubMed
Camnitz, P. S., Bost, W. S. (1985) Traumatic perforations of the tympanic membrane: Early closure with paper tape patching. Otolaryngology—Head and Neck Surgery, 93: 220223.CrossRefGoogle ScholarPubMed
Castler, J. D., Chait, R. H., Zajtchuk, J. T. (1989) Treatment of blast injury to the ear. Annals of Otology, Rhinology and Laryngology, Supplement 140: 1316.CrossRefGoogle Scholar
Chalat, N. J. (1971) Middle ear effects of head trauma. Laryngoscope, 81: 12861303.CrossRefGoogle Scholar
Chavanne, F. (1920) Rupture of the tympanum from shell explosions. Laryngoscope, 30: 441442.CrossRefGoogle Scholar
Christiansen, C. B. (1984) Photography in the treatment of tympanic membrane perforations. Journal of Laryngology and Otology, 98: 107111.CrossRefGoogle ScholarPubMed
Clawson, J. P., Litton, W. B. (1971) The healing process of tympanic membrane perforations. Transactions of the American Academy of Ophthalmology and Otolaryngology, 75: 13021312.Google ScholarPubMed
Colledge, L. (1921) Injuries to the ear in modern warfare. Journal of Laryngology and Otology, 36: 283287.CrossRefGoogle Scholar
Collins, E. G. (1944) Injury to the ears among battle casualties of the Western Desert. Journal of Laryngology and Otology, 59: 115.CrossRefGoogle Scholar
Cooper, G. J., Maynard, R. L., Cross, N. L., Hill, J. F. (1983) Casualties from terrorist bombings. Journal of Trauma, 23: 955967.CrossRefGoogle ScholarPubMed
Craig, D. H. (1940) Explosion injuries of the ear. Practitioner, 145: 400404.Google Scholar
Craig, D. H. (1944) Blast injuries of the ear. Journal of Laryngology and Otology, 59: 443456.CrossRefGoogle Scholar
Dabney, S. G. (1904) Rupture of the membrana tympani. Medical Age, 22: 286290.Google Scholar
Derlacki, E. L. (1953) Repair of central perforations of tympanic membrane. Archives of Otolaryngology, 58: 405420.CrossRefGoogle ScholarPubMed
Derlacki, E. L. (1973) Office closure of central tympanic membrane perforations: A quarter century of experience. Transactions of the American Academy of Ophthalmology and Otolaryngology, 77: 5366.Google ScholarPubMed
DeWeese, D. D., Saunders, W. H. (1973) Textbook of Otolaryngology. Mosby Company, St Louis.Google Scholar
Dominguez, R. H. (1986) Water polo injuries. Clinical Sports Medicine, 5: 169183.CrossRefGoogle ScholarPubMed
Dragovich, J. J. (1962) Closure of tympanic membrane perforations. Archives of Otolaryngology, 75: 206207.CrossRefGoogle ScholarPubMed
Dunlap, A. M., Schuknecht, H. F. (1947) Closure of perforations of the tympanic membrane. Laryngoscope, 57: 479490.CrossRefGoogle ScholarPubMed
Eckel, W. (1959) Die gutachtliche Beurteilung von Ohrcholesteatomen nach Traumen. Hals Nasen Ohrenheilkunde, 7: 235242.Google Scholar
Eckel, W. (1966) Das traumatische Cholesteatom des Gehörorgans. Zeitschrift für Laryngologie, Rhinologie, Otologie und ihre Grenzgebiete, 45: 265274.Google Scholar
Escher, F. (1954) Traumatische Cholesteatome. Practica Oto-Rhino-Laryngologica, 16: 3240.Google Scholar
Escher, F. (1964) Funktionelle Ohrchirurgie traumatischer Mittelohrlüsionen. In Fortschritte der Hals-Nasen-Ohrenheilkund, Vol. 11, Ohrchirurgie traumatischer Mittelohrläsionen, Tracheotomie, die Tonsillektomie nach Sludder (Rüedi, L., ed.), Karger, Basel, p 150.Google Scholar
Fleischer, K., (1972) Das alternde Ohr: Morphologische Aspekte. HNO, 20: 103107.Google Scholar
Folbre, T. W. (1947) Blast rupture of the tympanic membrane. Texas Medicine, 43: 397400.Google ScholarPubMed
Foxen, E. H. M. (1972) Lecture Notes on Diseases of the Ear, Nose and Throat. Blackwell Scientific Publications, Oxford.Google Scholar
Frenkiel, S., Alberti, P. W. (1977) Traumatic thermal injuries of the middle ear. Journal of Otolaryngology, 6: 1722.Google ScholarPubMed
Friedman, O. (1948) Blast injuries of the ears. Archives of Otolaryngology, 47: 471484.CrossRefGoogle ScholarPubMed
Gapanavicius, B. G., Brama, I., Chisin, R. (1977) Early repair of blast ruptures of the tympanic membrane. Journal of Laryngology and Otology, 91: 565573.CrossRefGoogle Scholar
Govaerts, P. J., Jacob, W. A., Marquet, J. (1988) Histological study of the thin replacement membrane of human tympanic membrane perforations. Acta Oto-Laryngologica (Stockholm), 105: 297302.CrossRefGoogle ScholarPubMed
Griffin, W. L. (1979) A retrospective study of traumatic tympanic membrane perforations in a clinical practice. Laryngoscope, 89: 261282.CrossRefGoogle Scholar
Gruber, J. (1870) Lehrbuch der Ohrenheilkunde mit besonderer Rücksicht auf Anatomie und Physiologie. Carl Gerold's Sohn, Wien.Google Scholar
Güttich, H. (1959) Trommelfellverbrennung ohne Gehoögangsverbrennung bei Schweissern und Eisenbrennern. Hals Nasen Ohrenheilkunde, 7: 273274.Google Scholar
Hamit, H. F. (1973) Primary blast injuries. Industrial Medicine, 42: 1421.Google ScholarPubMed
Hartmann, A. (1889) Die Krankheiten des Ohres und deren Behandlung. Verlag von Fischer's Medicinische Buchhandlung, Berlin.CrossRefGoogle Scholar
Haynes, R. C.Murad, F. (1985) Adrenocorticotropic hormone, adrenocortical steroids and their synthetic analogs, inhibitors of adrenocortical steroid biosynthesis. In The Pharmacological Basis of Therapeutics (Gilman, A. G., Goodman, L. S., Rall, T. W., Murad, F. eds.). Macmillan Publishing Company, New York, p 14591489.Google Scholar
Heermann, O. (1936) Über einige Fälle von Gehörgangs, Mittelohr-und Labyrinthverbrennungen beim Schweissen und Giessen. Zeitschrift für Hals, Nasen und Ohrenheilkunde, 39: 546556.Google Scholar
Henry, G. A. (1945) Blast injuries of the ear. Laryngoscope, 55: 663672.CrossRefGoogle ScholarPubMed
Herrmann, R. (1966) Die Prognose der Spontanheilung bei Trommelfellverletzungen. Zeitschrift für Laryngologie, Rhinologie, Otologie und ihre Grenzgebiete, 45: 283286.Google Scholar
Hepskind, M. M. (1957) Auditory impairment due to battle incurred acoustic trauma. In Surgery in World War II: Ophthalmology and Otolaryngology (Coates, J. B., Randolph, M. E., Canfield, N., McFetridge, E. M., eds.). Office of the Surgeon General, Department of the Army, Washington, DC, p 489511.Google Scholar
Hollender, A. R. (1965) Office practice of otolaryngology. Davis Company, Philadelphia.Google Scholar
Hollinger, J. (1903) Perforation of the drumhead bytampons. Illinois Medical Journal, 5: 592593.Google Scholar
Hough, J. V. D. (1979) Otologie trauma. In Otolaryngology, Vol. 2, The Ear (Paparella, M. M., Schumnich, D. A., eds.). Saunders Company, Philadelphia, p 241262.Google Scholar
Hugh, G. S. F. (1946) Traumatic perforation of the ear drums. Virginia Medical, 73: 504505.Google Scholar
Imhofer, R. (1920) Gerichtliche Ohrenheilkunde. Kabitzsch, Leipzig.Google Scholar
Ireland, P. E. (1946) Traumatic perforations of tympanic membrane due to blast injury. Canadian Medical Assocation Journal, 54: 256258.Google ScholarPubMed
Johnson, A., Hawke, M. (1985) An ultrastructural study of the skin of the tympanic membrane and external ear canal of the guinea pig. Journal of Otolaryngology, 14: 357364.Google ScholarPubMed
Johnson, A., Hawke, M. (1987) The function of migratory epidermis in the healing of tympanic membrane perforations in guinea pig. Acta-Oto-Laryngologica (Stockholm), 103: 8186.CrossRefGoogle ScholarPubMed
Jones, H. M. (1905) Drawing of a traumatic perforation of the tympanic membrane. Journal of Laryngology and Otology, 20: 157159.Google Scholar
Jordan, L. W. (1952) Traumatic rupture of the tympanic membrane. Laryngoscope, 62: 615622.CrossRefGoogle ScholarPubMed
Juers, A. L. (1958) Office closure of tympanic perforations: a new approach. Laryngoscope, 68: 12071215.CrossRefGoogle ScholarPubMed
Juers, A. L. (1963) Perforation closure by marginal eversion. Archives of Otolaryngologica, 77: 7680.CrossRefGoogle ScholarPubMed
Juers, A. L. (1974) Traumatic tympanic perforation. Transactions of the American Academy of Ophthalmology and Otolaryngology, 78: 261263.Google ScholarPubMed
Kanimturk, E. (1979) Clinical evaluation of traumatic perforations of the tympanic membrane. International Review of the Army, Navy and Air Force Medical Services, 6: 523526.Google Scholar
Kelemen, G. (1934) Traumatische Cholesteatomgenese. Acta Oto-Laryngologica (Stockholm), 20: 211230.CrossRefGoogle Scholar
Keller, A. P. (1958) A study of the relationship of air pressure to myringorupture. Laryngoscope, 68: 20152029.CrossRefGoogle ScholarPubMed
Kerr, A. G., Byrne, J. E. T. (1975) Concussive effects of bomb blast on the ear. Journal of Laryngology and Otology, 89: 131143.CrossRefGoogle Scholar
Kerr, A. G., Smyth, G. D. L. (1979) Ear trauma. In Clinical Otolaryngology (Maran, A. G. D., Stell, P. M., eds.). Blackwell Scientific Publications, Oxford, p 108122.Google Scholar
Kerr, A. G., Smyth, G. D. L. (1987) Ear Trauma. In Scott-Brown's Otolaryngology, vol. 3, Otology (Booth, J. B., ed). Butterworths, London, p 172184.Google Scholar
Korkis, F. B. (1946) Rupture of the tympanic membrane of blast origin. Journal of Laryngology and Otology, 61: 367390.CrossRefGoogle Scholar
Kristensen, S., Juul, A., Gammelgaard, N. P., Rasmussen, O. R. (1989) Traumatic tympanic membrane perforations: Complications and management. Ear, Nose and Throat Journal, 68: 503516.Google ScholarPubMed
Kronenberg, J., Shoshan, J. B., Modan, M., Leventon, G. (1988) Blast injury and cholesteatoma. American Journal of Otology, 9: 127130.Google ScholarPubMed
Lester, J. C.Gomez, V. (1898) Observations made in the caisson of the New East River Bridge as to the effects of compressed air upon the human ear. Archives of Otology, 27: 119.Google Scholar
Levy, A. (1896) Bericht über die Wirksamkeit der Klinik und Poliklinik für Ohren-, Nasen-, Schlund- und Kehlkopfkrankheiten des Garnisonkrankenhauses zu Kopenhagen für die Jahre 1888–1893. Zeitschrift für Ohrenheilkunde. 29: 202213.Google Scholar
Liavaag, G., Møller, P., Lind, O. (1986) Traumatiske trommehinneperforasjoner. Tidsskrift for Den Norske Laegeforening, 106: 817819.Google Scholar
Lim, D. J. (1970) Human tympanic membrane: An ultrastructural observation. Acta Oto-Laryngologica (Stockholm), 70: 176186.CrossRefGoogle ScholarPubMed
Lindeman, R. C. (1979) Temporal bone trauma and facial paralysis. In The Otolaryngologic Clinics of North America, Vol. 12, Symposium on Otolaryngologic and Head and Neck Emergencies, (Yarington, C. T., ed.). Saunders Company,Philadelphia, p 403413.CrossRefGoogle Scholar
Lindeman, P., Edström, S., Granström, G., Jacobsson, S., Sydow, C. V., Westin, T., Åberg, B. (1987) Acute traumatic tympanic membrane perforations: Cover or observe. Archives of Otolaryngology—Head and neck Surgery, 113: 12851287.CrossRefGoogle ScholarPubMed
Litton, W. B. (1968) Epithelial migration in the ear. Acta Oto-Laryngologica (Stockholm), Supplement 240: 139.Google Scholar
Lukan, N. (1991) Burn injuries of the middle ear. ORL: Journal of Oto-Rhino-Laryngology and Its Related Specialties, 53: 140142.CrossRefGoogle ScholarPubMed
Makino, K., Amatsu, M. (1986) Epithelial migration on the tympanic membrane and external canal. Archives of Oto-Rhino-Laryngology, 243: 3942.CrossRefGoogle ScholarPubMed
Martin, H., Gignoux, B., Oudot, J., Chalard, R. (1980) Des brulures du tympan et de la caisse. Journal Françaises de Otorhinolaryngologie et Chirurgie Maxillofaciale, 21: 885889.Google Scholar
Mawson, S. R., Ludman, H. (1979) Diseases of the Ear: A Textbook of Otology. Edward Arnold Publishers, London.Google Scholar
McIntire, C., Benitez, J. T. (1970) Spontaneous repair of the tympanic membrane: Histopathological studies in the cat. Annals of Otology, Rhinology and Laryngology, 79: 11291131.CrossRefGoogle Scholar
McMinn, R. M. H., Taylor, M. (1966) The cytology of repair in experimental perforations of the tympanic membrane. British Journal of Surgery, 53: 222232.CrossRefGoogle ScholarPubMed
McReynolds, G. S., Guildford, F. R., Chase, G. R. (1949) Blast injuries to the ear: The Texas City disaster. Archives of Otolaryngology, 50: 18.CrossRefGoogle Scholar
Merwin, G. E., Boies, L. R. (1980) Paper patch repair of blast rupture of the tympanic membrane. Laryngoscope, 90: 853860.CrossRefGoogle ScholarPubMed
Mosher, W. F. (1942) Foreign bodies of external canal, middle ear and mastoid and their complications. Archives of Otolaryngology, 36: 679686.CrossRefGoogle Scholar
Möbius, M. (1964) Schweissperlenverletzungen des Trommelfelles. HNO, 12: 1822.Google Scholar
O'Donoghue, G. M. (1983) Epithelial migration on the guinea pig tympanic membrane: The influence of perforation and ventilation tube insertion. Clinical Otolaryngology, 8: 297300.Google Scholar
Oppenheimer, P., Kaplan, J., Harrison, W., Gandhi, K. (1961) Repair of traumatic myringorupture. Archives of Otolaryngology, 73: 328333.CrossRefGoogle ScholarPubMed
Pahor, A. L. (1979) Blast injuries to the ear: A historical and literary review. Journal of Laryngology and Otology, 93: 225251.CrossRefGoogle Scholar
Pahor, A. L. (1981) The ENT problems following the Birmingham bombings. Journal of Laryngology and Otology, 95: 399406.CrossRefGoogle ScholarPubMed
Palmer, G. W. (1943) Blast perforation of eardrums. British Medical Journal, 11: 233.CrossRefGoogle Scholar
Passow, A. (1905) Verletzungen des Trommelfells. In Die Ohrenheilkunde der Gegenwart und ihre Grenzgebiete, Vol. 5, Die Verletzungen des Gehörorganes (Korner, O., ed.) Bergmann, Wiesbaden, p 4668.Google Scholar
Plester, D. (1972) Das alternde Ohr: Chirurgische Aspekte. HNO, 20: 216217.Google Scholar
Politzer, A. (1872) Über traumatische Trommelfellrupturen mit besonderer Rücksicht auf die forensische Praxis I. Wiener Medizinische Wochenschrift, 22: 881883.Google Scholar
Politzer, A. (1872) Über traumatische Trommelfellrupturen mit besonderer Rücksicht auf die forensische Praxis II. Wiener Medizinische Wochenschrift, 22: 901904.Google Scholar
Pulec, J. L., Kinney, S. E. (1973) Diseases of the tympanic membrane. In Otolaryngology, Vol. 2, The Ear (Paparella, M. M., Schummick, D. A., eds.). Saunders Company, Philadelphia, p 5574.Google Scholar
Reeve, D. R. E. (1977) Repair of large experimental perforations of the tympanic membrane. Journal of Laryngology and Otology, 91: 767778.CrossRefGoogle ScholarPubMed
Reijnen, C. J. H., Kuijpers, W. (1971) The healing pattern of the drum membrane. Acta Oto-Laryngologica (Stockholm), Supplement 287: 174.Google ScholarPubMed
Rice, A. H. (1949) Blast perforation of the ear drum. Archives Otolaryngologica, 49: 316330.CrossRefGoogle ScholarPubMed
Rogers, K. A., Snow, J. B. (1968) Closure of experimental tympanic membrane perforations. Annals of Otology, Rhinology and Laryngology, 77: 6671.CrossRefGoogle ScholarPubMed
Roosa, D. B. S. J. (1876) A practical treatise on the diseases of the ear including the anatomy of the organ. William Wood & Company, New York.Google Scholar
Ruggles, R. L., Votypka, R. (1973) Blast injuries of the ear. Laryngoscope, 83: 974976.CrossRefGoogle ScholarPubMed
Rybak, L. P., Johnson, D. W. (1983) Tympanic membrane perforations from water sports: Treatment and outcome. Otolaryngology, 91: 659662.CrossRefGoogle ScholarPubMed
Sade, J. (1978) Pathogenesis of attic cholesteatomas. Journal of the Royal Society of Medicine, 71: 716732.CrossRefGoogle ScholarPubMed
Schein, G. C. (1955) Thermal effects on the tympanic membrane. Laryngoscope, 65: 10431056.CrossRefGoogle ScholarPubMed
Schmiegelow, E. (1912) Ørets Sygdomme: Fremstillede for Praktiserende Laeger og Studerende. Nordisk Forlag, Copenhagen.Google Scholar
Seaman, R. W., Newell, R. C. (1971) Another etiology of middle ear cholesteatoma. Archives of Otolaryngology, 94: 440442.CrossRefGoogle ScholarPubMed
Seifi, A. E. (1976) Emergency repair of traumatic drumtears. ORL: Journal of Oto-Rhino-Laryngology and its Related Specialties, 38: 294297.CrossRefGoogle Scholar
Sexton, S. (1887) Injury of the ear caused by the blast of a bursting shell: With some remarks on the effects of explosives on the organ of hearing in warfare. Medical Journal, 31: 201208.Google Scholar
Shambaugh, G. E., Glasscock, M. E. (1980) Surgery of the Ear. Saunders Company, Philadelphia.Google Scholar
Shimada, T., Lim, D. J. (1971) The fiber arrangement of the human tympanic membrane: A scanning electron microscopic observation. Annals of Otology, Rhinology and Laryngology, 80: 210217.CrossRefGoogle ScholarPubMed
Silcox, L. E., Schenck, H. P. (1944) Blast injury of the ears. Archives of Otolaryngology, 39: 413420.CrossRefGoogle Scholar
Silverstein, H., Fabian, R. L., Stool, S. E., Hong, S. W. (1973) Penetrating wounds of the tympanic membrane and ossicular chain. Transactions of the American Academy of Ophthalmology and Otolaryngology, 77: 125135.Google ScholarPubMed
Simmons, F. B. (1961) Epithelial migration in central type tympanic perforations. Archives of Otolaryngology, 74: 435437.CrossRefGoogle ScholarPubMed
Singh, D., Ahluwalia, K. J. S. (1968) Blast injuries of the ear. Journal of Laryngology and Otology, 82: 10171028.CrossRefGoogle ScholarPubMed
Smallman, L. A., Johnson, A.P., Kent, S. E. (1989) The role of the different layers in healing of perforations of guinea pig tympanic membrane. A two dimensional histologic study. In Cholesteatoma and Mastoid Surgery: Proceedings of the III Conference on Cholesteatoma and Mastoid Surgery, Copenhagen, Denmark,June 5–9, 1988 (Tos, M., Thomsen, J., Peitersen, E., eds.). Kugler & Ghedini Publications,Amsterdam, p 297302.Google Scholar
Snow, J. B. (1988) Management and therapy of trauma to the external ear and auditory and vestibular systems. In Otologic Medicine and Surgery (Alberti, P. W.Ruben, R. J., eds.). Churchill Livingstone, New York, p 15611576.Google Scholar
Söderberg, O., Hellström, S., Stenfors, L. E. (1984) Myringotomy made by CO2 laser. An alternative to the ventilation tube. Acta Oto-Laryngologica (Stockholm), 97: 335341.CrossRefGoogle Scholar
Söderberg, O., Hellström, S., Stenfors, L. E. (1985) The healing pattern of experimental heat myringotomy. Revue de Laryngologie, Otologie, et Rhinologie, 106: 8185.Google ScholarPubMed
Spandow, O., Hellström, S., Schmidt, S. H. (1990) Hydrocortisone delay of tissue repair of experimental tympanic membrane perforations. Annals of Otology, Rhinology and Laryngology, 99: 647653.CrossRefGoogle ScholarPubMed
Stage, J., Vinding, T. (1986) Metal spark perforation of the tympanic membrane with deafness and facial paralysis. Journal of Laryngology and Otology, 100: 699700.CrossRefGoogle ScholarPubMed
Stenfors, L. E., Carlsöö, B., Salén, B., Winblad, B. (1980) Repair of experimental tympanic membrane perforations. Acta Oto-Laryngologica (Stockholm), 90: 332341.CrossRefGoogle ScholarPubMed
Stenfors, L. E., Carlsöö, B., Winblad, B. (1981) Structure and healing capacity of the rat tympanic membrane after eustachian tube occlusion. Acta Oto-Laryngologica (Stockholm), 91: 7584.CrossRefGoogle Scholar
Stewart, W. R. H. (1889) Cases of ruptured membrana tympani from boxing the ears: Loss of taste following perforation of the drumhead. Lancet, 1: 574575.CrossRefGoogle Scholar
Stinson, W. D. (1936) Reparative processes in the membrana tympani: Some interesting manifestations. Archives of Otolaryngology, 24: 600605.CrossRefGoogle Scholar
Stinson, W. D. (1941) Closure of perforations of membrana tympani with Cargile's membrane. Annals of Otology, Rhinology and Laryngology, 50: 178181.CrossRefGoogle Scholar
Storrs, L. (1983) Tympanic membrane perforation. In Current Therapy in Otolaryngology, Head and Neck Surgery 1982–1983 (Gates, G. A., ed.) Trenton & Decker, London, p 1114.Google Scholar
Strohm, M. (1986) Trauma of the middle ear: Clinical findings, postmortem observations and results of experimental studies. In: Advances in Otorhinolaryngology, Vol. 35 (Pfaltz, C. R., ed.) Karger, Basel.Google Scholar
Sudderth, M. E. (1974) Tympanoplasty in blast induced perforation. Archives of Otolaryngology, 99: 157159.CrossRefGoogle ScholarPubMed
Taylor, M., McMinn, R. M. H. (1965) Healing of experimental perforations of the tympanic membrane. Journal of Laryngology and Otology, 79: 148158.CrossRefGoogle ScholarPubMed
Taylor, M., McMinn, R. M. H. (1967) Cytology of repair in experimental perforations of the tympanic membrane and its relationship to chronic perforations in man. Transactions of the American Academy of Ophthalmology and Otolaryngology, 71: 802812.Google ScholarPubMed
Thulin, A. (1947) Traumatic cholesteatoma. Acta Oto-Laryngologica (Stockholm), 35: 575582.CrossRefGoogle Scholar
Tos, M. (1973) Course of and sequelae to 248 petrosal fractures. Acta Oto-Laryngologica (Stockholm), 75: 353354.CrossRefGoogle ScholarPubMed
Tos, M., Thomsen, J., Peitersen, E. (1990) Cholesteatoma and Mastoid Surgery: Proceedings of the III Conference on Cholesteatoma and Mastoid Surgery, Copenhagen, Denmark,June 5–9, 1988.Kugler and Ghedini Publications,Amsterdam.Google Scholar
Toynbee, J. (1860) The Diseases of the Ear: Their Nature, Diagnosis and Treatment. Churchill, London.Google Scholar
Trautmann, D. (1873) Über die Continuitätstrennungen des Trommelfells. Deutsche Militärärztliche Zeitschrift, 2: 422434.Google Scholar
Ulrich, K. (1926) Verletzungen des Gehörorgans bei Schadelbäsisfrakturen. Acta Oto-Laryngologica (Stockholm), Supplement 6: 1150.Google Scholar
Vick, U. (1978) Verbrennungen des Mittelohres durch Schweissperlen. Zeitschrift für Ärztliche Fortbildung, 72: 726728.Google Scholar
Wehmer, R. (1885) Über Verletzungen des Ohres vom gerichsärztlichen Standpunkte aus. In Freidreich's Blätter für gerichtliche Medicin und Sanitätspolizei (Kerschensteiner, J., ed). Verlag der Friedrich Korn'schen Buchhandlung, Nürnberg, p 26–458.Google Scholar
Weinstein, L. (1970) The sulfonamides. In The Pharmacological Basis of Therapeutics (Goodman, L. S., Gilman, A., eds.). Macmillan Publishing Company, New York, p. 11771203.Google Scholar
Weiss, K. S. (1980) Otologic lightning bolts. American Journal of Otolaryngology, 1: 334337.Google Scholar
Wilson, D. F. (1981) Tympanic membrane perforations secondary to ventilation devices: Special considerations. Laryngoscope, 91: 877882.CrossRefGoogle ScholarPubMed
Wilson, W. H. (1944) Prevention of traumatic deafness: Further studies. Archives of Otolaryngology, 40: 5259.CrossRefGoogle Scholar
Woodruff, H. W. (1898) Rupture of the tympanic membrane by indirect violence. Laryngoscope, 4: 181184.CrossRefGoogle Scholar
Wright, W. K. (1956) Repair of chronic central perforations of the tympanic membrane: by repeated acid cautery, by skin grafting. Laryngoscope, 66: 14641487.CrossRefGoogle ScholarPubMed
Wright, J. W., Silk, K. L. (1974) Acoustic and vestibular defects in lightning survivors. Laryngoscope, 84: 13781386.CrossRefGoogle ScholarPubMed
Yamashita, T. (1985) Histology of the tympanic perforation and the replacement membrane. Acta Oto-Laryngologica (Stockholm), 100: 6671.CrossRefGoogle ScholarPubMed
Yanagisawa, E., Kmucha, S. (1989) Diseases of the external and middle ear. In Textbook of Otolaryngology and Head and Neck Surgery (Lee, K. J., ed.). Elsevier Science Publishing Company, New York, p 63102.Google Scholar
Zuafal, E. (1873) Casuistische Beiträge zu den traumatischen Verletzungen des Trommelfelles I. Archiv für Ohrenheilkunde, 7: 188205.CrossRefGoogle Scholar
Zaufal, E. (1874) Casuistische Beiträge zu den traumatischen Verletzungen des Trommelfelles II. Archiv für Ohrenheilkunde, 8: 3149.CrossRefGoogle Scholar
Ziv, M., Philipsohn, N. C.Leventon, G., Man, A. (1973) Blast injury of the ear: Treatment and evaluation. Military Medicine, 138: 811813.CrossRefGoogle ScholarPubMed
Zuckerman, S. (1940) Discussion on the problem of blast injuries. Proceedings of the Royal Society of Medicine, 34: 171188.Google Scholar