{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T06:01:27Z","timestamp":1784786487797,"version":"3.55.0"},"reference-count":5,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2012,9,5]],"date-time":"2012-09-05T00:00:00Z","timestamp":1346803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To review our tympanoplasty results for blast\u2010induced tympanic membrane perforations and evaluate the association of various clinical factors with surgical success.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case series with chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Two tertiary military healthcare institutions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a retrospective review of all patients who had nonrevision tympanoplasty during a 1\u2010year period for blast\u2010induced perforations by the 2\u00a0neurotologists at Walter Reed Army Medical Center and National Naval Medical Center. Various perioperative clinical factors were analyzed for relations to successful perforation closure, the need for a second operation, and postoperative hearing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010four patients met inclusion criteria. All were male, and the average age was 24.0 years. Twenty\u2010two (65%) were total or near\u2010total perforations, of which 12 (35%) were repaired using lateral graft technique. The remainder had various medial graft procedures. Ossicular abnormalities were found in 6 (18%) patients. Cholesteatoma was discovered in 3 (9%) patients. Closure was complete in 82% of patients. The incomplete closures were with large perforations, those with foreign bodies (shrapnel), and in 1 with postoperative water exposure. There were no major complications, and the mean conductive hearing improvement was 11.3\u00a0dB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Blast\u2010induced tympanic membrane perforations are common in our population of wounded warriors. These cases are challenging because most have total or near\u2010total perforations, the ossicles can be out of place, the blast itself can implant epithelium in the middle ear, and foreign bodies can create a hostile middle ear environment. However, given attention to detail, we found that standard tympanoplasty techniques work well.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599812459326","type":"journal-article","created":{"date-parts":[[2012,9,6]],"date-time":"2012-09-06T01:12:29Z","timestamp":1346893949000},"page":"103-107","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Tympanoplasty for Blast\u2010Induced Perforations"],"prefix":"10.1002","volume":"148","author":[{"given":"Shankar K.","family":"Sridhara","sequence":"first","affiliation":[{"name":"Walter Reed National Military Medical Center Department of Otolaryngology Head &amp; Neck Surgery Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaldo","family":"Rivera","sequence":"additional","affiliation":[{"name":"Walter Reed National Military Medical Center Department of Otolaryngology Head &amp; Neck Surgery Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Littlefield","sequence":"additional","affiliation":[{"name":"Walter Reed National Military Medical Center Department of Otolaryngology Head &amp; Neck Surgery Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,9,5]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-1-4160-4665-3.00009-3"},{"issue":"2","key":"e_1_2_9_3_2","first-page":"S174","article-title":"Tympanic membrane perforation and hearing loss from blast overpressure in Operation Enduring Freedom and Operation Iraqi Freedom wounded","volume":"64","author":"Ritenour AE","year":"2008","journal-title":"J Trauma"},{"key":"e_1_2_9_4_2","first-page":"353","volume-title":"Explosion and Blast\u2010Related Injuries","author":"Branica S","year":"2008"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198207000-00002"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1515\/JBCPP.2008.19.3-4.185"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599812459326","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599812459326","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599812459326","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:55:12Z","timestamp":1760957712000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599812459326"}},"subtitle":["The Walter Reed Experience"],"short-title":[],"issued":{"date-parts":[[2012,9,5]]},"references-count":5,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013,1]]}},"alternative-id":["10.1177\/0194599812459326"],"URL":"https:\/\/doi.org\/10.1177\/0194599812459326","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,9,5]]},"assertion":[{"value":"2012-06-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-08-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2012-09-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}