Incidence of Tympanic Membrane Perforation Affected by Intratympanic Steroid Injection: A Retrospective Review

Abstract

Objective: This study aims to determine the incidence of persistent tympanic membrane perforation following intratympanic steroid injection and to identify potential factors associated with delayed healing. Additionally, it aims to estimate the time required for perforation closure in prolonged cases to avoid unnecessary interventions. Materials and Methods: Data from patients who underwent intratympanic steroid injections were reviewed. The primary outcome was the incidence of tympanic membrane perforation lasting beyond four weeks post-injection. Secondary outcomes included identifying factors affecting healing duration and closure time in prolonged cases. Results: Of 295 ears treated between March 2018 and March 2021, 3.39% (10/295) experienced persistent perforation at four weeks. Of these, 1.69% (5/295) required intervention, while the rest healed spontaneously. The median closure time was 12 weeks. All patients with persistent perforation were female. No statistically significant differences were found between groups. Hearing recovery was achieved in 29.1% (74/254) of patients with sudden sensorineural hearing loss. Younger age and non-profound hearing loss were favorable prognostic factors. Conclusion: The incidence of perforation in this study is lower than that previously reported but consistent with other studies in the literature. Intratympanic steroid injections remain beneficial, outweighing the risks of complications.