What follow-up care is indicated for patients treated for tympanic membrane perforation (TMP)?

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

Risk of cholesteatoma formation, either through the natural course of the disease or from squamous epithelium trapped during treatment, requires regular follow-up care for all patients postoperatively. Several annual visits should be the minimum once tympanic membrane perforation (TMP) healing is verified. Untreated TMP may not require regular follow-up care if a patient can be relied upon to seek medical advice if hearing changes or persistent drainage from the ear is noted. Location of the TMP informs the timing and frequency of follow-up care. Perforations in the pars tensa (stiff portion of the drum) are less likely to lead to complications.

The exceptions are pars tensa perforations located at the annulus or rim of the tympanic membrane. Tympanic membrane perforations (TMPs) in this location are at risk of developing middle ear cholesteatoma from migration of surface epithelium into the middle ear. Perforations in the pars flaccida (the portion without a fibrous center layer) are more frequently associated with complications and require more frequent follow-up care.


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