Traumatic perforations of the tympanic membrane: Observe or repair?

Traumatic perforations of the tympanic membrane deserve the same careful attention as any other injury, and healing should not invariably be left to chance. Sometimes early repair is clearly indicated. A foreign object rupturing the posterosuperior quadrant may cause obscure damage to the ossicular chain, a perilymphatic leak, or leave an unsuspected foreign body in the middle ear. All very large traumatic perforations and all perforations in the posterosuperior quadrant should be repaired promptly to reduce the incidence of permanent impairment. Small perforations in less vulnerable quadrants can be treated in the traditional expectant manner. Steroid-containing ear drops inhibit healing and are contraindicated in the-treatment of traumatic perforations. [ABSTRACT FROM AUTHOR]