{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:27:02Z","timestamp":1791329222049,"version":"4.3.1"},"reference-count":15,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,11,26]],"date-time":"2016-11-26T00:00:00Z","timestamp":1480118400000},"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":[[2017,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe characteristics of blast\u2010induced tympanic membrane perforations that do not spontaneously heal, evaluate the outcomes of tympanoplasty techniques, and understand the factors associated with surgical success.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Two tertiary military health care institutions.<\/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>Subjects and Methods<\/jats:title><jats:p>This study reviewed the practice of 1\u00a0military neurotologist and included all tympanoplasties for combat blast\u2010induced perforations from 2007 to 2012, which comprised a total of 55 patients. Surgical outcomes and associated perioperative factors were examined to include size, location, bilateral involvement, timing of surgery, and surgical technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010five patients (68 ears) met inclusion criteria. Thirty\u2010six (53%) were total or near\u2010total perforations, and 51% of patients had bilateral perforations. The overall success rate was 77%. It was 82% for lateral grafts and 70% for medial grafts, but the difference between these was not statistically significant. Age was a significant factor, with a success rate of 56% for ages 25 to 34 years, compared with 90% for 20 to 24 and &gt;34 years. Patients who had bilateral sequential tympanoplasties also had lower success rates than those who had only unilateral surgery (62% vs 87%, <jats:italic>P<\/jats:italic> =. 002). Ossicular disruptions were found in 5 ears, and cholesteatoma was discovered in 8. Surgical timing did not predict success, as the average time until repair was 153\u00a0days in successful cases and 151\u00a0days in failures. The mean conductive hearing improvement was 13.6\u00a0dB, and there were no major complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Tympanoplasty can be challenging in this population. Age and bilateral surgery were the only independent variables that showed significance.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599816677693","type":"journal-article","created":{"date-parts":[[2016,11,22]],"date-time":"2016-11-22T21:23:29Z","timestamp":1479849809000},"page":"353-359","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Tympanoplasty Outcomes for Blast\u2010Induced Perforations from Iraq and Afghanistan: 2007\u20102012"],"prefix":"10.1002","volume":"156","author":[{"given":"Sungjin A.","family":"Song","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Tripler Army Medical Center Honolulu Hawaii USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shankar K.","family":"Sridhara","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Dwight D. Eisenhower Army Medical Center Fort Gordon Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip D.","family":"Littlefield","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Tripler Army Medical Center Honolulu Hawaii USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,11,26]]},"reference":[{"issue":"2","key":"e_1_2_9_2_1","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_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215110002215"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000616"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016480310017045"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2012.01.010"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599811411143"},{"key":"e_1_2_9_8_1","first-page":"2662","article-title":"Blast injury of the ears: the experience from Yala Hospital, Southern Thailand","volume":"90","author":"Tungsinmunkong S","year":"2007","journal-title":"J Med Assoc Thai"},{"key":"e_1_2_9_9_1","first-page":"92","article-title":"Perforated tympanic membrane after blast injury","volume":"14","author":"Kronenberg J","year":"1993","journal-title":"Am J Otol"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/00034894890980S503"},{"key":"e_1_2_9_11_1","first-page":"642","article-title":"Tympanoplasty after war blast lesions of the eardrum: retrospective study","volume":"42","author":"Sprem N","year":"2001","journal-title":"Croat Med J"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812459326"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-1-4160-4665-3.00009-3"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000232495.77308.46"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/156.12.651"},{"key":"e_1_2_9_16_1","first-page":"92","article-title":"Perforated tympanic membrane after blast injury","volume":"14","author":"Kronenberg J","year":"1993","journal-title":"Am J Otol"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599816677693","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599816677693","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599816677693","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:23:01Z","timestamp":1760955781000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599816677693"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11,26]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,2]]}},"alternative-id":["10.1177\/0194599816677693"],"URL":"https:\/\/doi.org\/10.1177\/0194599816677693","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,11,26]]},"assertion":[{"value":"2016-07-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-10-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-11-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}