Can a tympanic membrane perforation (TMP) heal spontaneously?

Updated: Dec 14, 2020
  • Author: Robert A Saadi, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Many tympanic membrane perforations resolve spontaneously. At times, a perforation heals with a thin membrane consisting only of mucosal and squamous epithelial layers, without a fibrous middle layer. Such a neomembrane may be so thin that it is mistaken for an existing perforation instead of a healed one. [15] Neomembranes may retract deeply into the middle ear, sometimes making them more difficult to distinguish from actual perforations, particularly in the setting of coexisting ventilation issues and negative middle ear pressure. Examination under the operating microscope resolves ambiguity and is recommended. Deep retraction, especially in the posterior-superior quadrant of the drum, may cause erosion of the ossicles or precede cholesteatoma formation.


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