Forensic medical identification of traumatic tympanic membrane perforation

Objective The purpose of this study is to evaluate the clinical features in patients with a traumatic perforation of the tympanic membrane and to discuss its forensic implications. Methods Data of 308 cases (316 ears) suggestive of a traumatic perforation of the tympanic membrane were retrospectively analyzed. Results Of all suspected patients, 237 were finlly diagnosed as traumatic tympanic membrane perforation, 50 as having healed tympanic membranes, 6 with secondary infection; 11 cases had no perforation of the ear drum, in 8 cases the data excluded a contributory role of trauma in the tympanic membrane perforation, 1 case was diagnosed as chronic suppurative otitis media and 3 case remained uncertain. Conclusion The main criteria for diagnosis of traumatic tympanic membrane perforation are as follows:(1) a history of head or ear trauma; (2) aural symptoms (otalgia,deafness or hemorrhage in the external auditory canal); (3) slit- , spindle-, triangular-, or irregular-shaped perforations located in the parts tensa; (4) the affected ear failed tympanometry or showing type B tympanogram but with a bigger external canal volume; (5) eliminate those with chronic suppurative otitis media.