We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Traumatic Tympanic Membrane Perforations Diagnosed in Emergency Departments.
- Authors
Carniol, Eric T.; Bresler, Amishav; Shaigany, Kevin; Svider, Peter; Baredes, Soly; Eloy, Jean Anderson; Ying, Yu-Lan Mary
- Abstract
<bold>Importance: </bold>Tympanic membrane perforations (TMPs) are frequent events leading to evaluation in the primary care and otolaryngology offices or the emergency department (ED). Despite specific warning labels on packaging of cotton-tipped applicators regarding the risk of injury to the ear canal with personal use, these products are commonly used to remove ear cerumen.<bold>Objective: </bold>To analyze the mechanism of injury for traumatic TMPs among patients presenting to the ED.<bold>Design, Setting, and Participants: </bold>Cross-sectional analysis of cases from 100 emergency departments in the United States. The National Electronic Injury Surveillance System was searched on April 3, 2015, for ear-related injuries with analysis information regarding patient age, patient sex, time and date of injury, specific injury diagnoses, and specific injury mechanisms that occurred across 5 years, from January 1, 2010, through December 31, 2014.<bold>Main Outcomes and Measures: </bold>Diagnoses of traumatic TMP documented in the ED visit record as well as patient demographics, diagnoses, and other aspects of the injury, including mechanism of injury.<bold>Results: </bold>There were 949 case entries in the database for traumatic TMP, which extrapolates to 4852 ED visits nationally. Of 949 patients evaluated, 568 (59.8%) were men and 381 (40.2%) were women resulting in a male to female ratio of 1.49:1. Most injuries occurred in patients 18 years or younger (602 of 949 [63.4%]) with children younger than 6 years most at risk (331 of 949 [34.9%]). Ear canal instrumentation including foreign bodies was noted in 581 of 949 cases (61.2%), with cotton-tipped applicators noted in 261 (44.9%) of these cases. While foreign body instrumentation represented the leading cause of traumatic TMP in patients aged 0 to 5 years (284 of 331 cases [85.8%]), 6 to 12 years (108 of 158 [68.4%]), 19 to 36 years (85 of 223 [38.1%]), 37 to 54 years (48 of 91 [52.7%]), and 55 years or older (22 of 33 [66.7%]), water trauma was the leading cause of TMP in patients aged 13 to 18 years (43 of 113 cases [38.1%]).<bold>Conclusions and Relevance: </bold>Traumatic TMP represents a common reason for evaluation in the ED. Despite common warnings regarding risk of injury to the tympanic membrane with use of a cotton-tipped applicator, it is still a major cause of traumatic TMPs. Other injury mechanisms also play an important role in the teenage and young adult populations.
- Publication
JAMA Otolaryngology-Head & Neck Surgery, 2018, Vol 144, Issue 2, p136
- ISSN
2168-6181
- Publication type
journal article
- DOI
10.1001/jamaoto.2017.2550