prevalence of traumatic tympanic membrane perforation in patients with a patulous eustachian tube

background: with respect to physical relations in force and pressure, we hypothesized that the prevalence of traumatic tympanic membrane perforation in patients with a patulous eustachian tube is greater than normal, because in eustachian tube patency, the internal air pressure of the middle ear will not increase after compression, subsequent to trauma. therefore the force upon the tympanic membrane may cause it to perforate easier. methods: in this study we evaluated 45 patients with traumatic tympanic membrane perforation. after otoscopy, modified inflation-deflation test was performed to determine the opening, closing, and residual pressure of the eustachian tube. results: approximately 60 percent had a patulous eustachian tube, 27% had poor eustachian tube function and 13% had normal eustachian tube function. conclusion: it appears that patients with a patulous eustachian tube are probably at high risk for traumatic tympanic membrane perforation.