The objective of this study is to evaluate the effectiveness of 50% silver nitrate chemical cauterization compared to conservative management (spontaneous healing) in closing small, dry tympanic membrane perforations. Patients presenting with a small (\<4 mm), dry, unilateral tympanic membrane perforation will be assigned to either receive weekly applications of 50% silver nitrate for up to 4 weeks or undergo observation for spontaneous healing. The primary outcome is to assess and compare the proportion of patients achieving complete tympanic membrane closure after 4 weeks of follow-up
Patients aged between 18 and 60 years
Small, unilateral tympanic membrane perforation in the pars tensa (<25% of surface area, present in one quadrant)
Dry perforation for at least 4 weeks
Perforation size <4 mm in diameter
Age <18 years or >60 years
Bilateral tympanic membrane perforations
Perforation size >4 mm in diameter
Discharging ear
Parallel
50% Silver Nitrate Cauterization
DrugUnder microscopic visualization, 50% silver nitrate is applied to the margins of the tympanic membrane perforation until blanching occurs, followed by Gel foam placement. The procedure is repeated weekly for up to 4 weeks.
Tympanic Membrane Perforation Closure Rate
Proportion of participants achieving complete closure (healing) of the tympanic membrane without any residual defect, confirmed by otoscopic examination.
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Muhammad Ali Javed
Lead sponsor
Rawalpindi Medical College
Sponsor institution
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