The repair of central perforations of the tympanic membrane was seldom attempted and received little mention prior to World War II. Due to the impetus of the large number of traumatic drum injuries during this period, more interest has been focused on closure in the past 15 years.
The ear must be dry before closure is attempted, although the length of duration of the previous otitis media or size of the perforation is no restriction to therapy. Contraindications, however, include mastoid disease, cholesteatoma, marginal or attic perforations, and persistent tubal obstruction even after nasal abnormalities are corrected. Varying methods of closure have been employed, both surgical and nonsurgical. The former consists of free skin or vein graft, while the latter employs scarifying the edges of the perforation with trichloracetic acid and placing a prosthesis over the perforation either to act as a scaffold or on which solutions can be placed
DRAGOVICH JJ. Closure of Tympanic Membrane Perforations. Arch Otolaryngol. 1962;75(3):206–207. doi:10.1001/archotol.1962.00740040214005
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