What is the most common treatment approach for tympanic membrane perforation?

In cases of tympanic membrane perforation, the most common treatment approach is observation. This is primarily because many small perforations will heal spontaneously without intervention. The natural healing process can take several weeks to a few months, and in the absence of significant symptoms such as persistent otorrhea or severe pain, monitoring the injury is typically sufficient.

Observation is effective for small to moderate perforations that are not associated with complications like cholesteatoma or recurrent infections. During this period, it is important for patients to keep the ear dry and to avoid putting any objects in the ear canal, which could further complicate the healing process.

While surgical repair may be indicated for larger or non-healing perforations, this is not the standard initial approach for most cases. Likewise, immediate antibiotic therapy is not universally required unless there is clear evidence of infection or other complicating factors. Intranasal steroids do not play a role in treating tympanic membrane perforations and are typically used for conditions related to nasal inflammation or allergies.

Therefore, observation serves as the most appropriate and common strategy for managing tympanic membrane perforations, allowing for the potential for natural recovery without unnecessary interventions.