Objective The goal of this study was to evaluate the effects of crust formation on the healing of traumatic, dry, and minor-sized tympanic membrane perforations (TMPs) in humans. Study design Case series with a chart review. Setting Tertiary university hospital. Materials and methods The clinical records of patients with traumatic TMPs who met the case selection criteria were retrieved and categorized according to the presence of a crust and the timing of crust formation into three groups: no crust, early crust formation, and late crust formation. Healing outcomes (i.e., healing rate and time) in the three groups were analyzed. Results In total, 83 patients were analyzed. The perforation closure rates were 92%, 100%, and 78% in the groups with no-crust, early crust formation, and late crust formation, respectively. No significant difference was seen between the groups with no-crust and with late crust formation (p > 0.05). By contrast, closure rates differed significantly between the early and late crust formation groups (p < 0.05). Overall, the no-crust and early crust formation groups showed shorter healing times compared with the late crust formation group (p < 0.05). However, closure times did not differ significantly between groups with early crust formation and no crust (p > 0.05). Conclusions Crust formation at the margin of a traumatic TMP may serve as a predictor of healing outcome. Compared with perforations with early crust formation or no crust, late crust formation can result in delayed healing and failure to close completely.
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