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Tympanoplasty in children--a prospective study
Y Bajaj1, A S Bais, B Mukherjee
1Department of Otorhinolaryngology and Head and Neck Surgery, Lady Hardinge Medical College, Delhi, India.
Insights
Type I tympanoplasty is a successful surgical option for children with central eardrum perforations. This study found a 91.1% success rate, with age not impacting outcomes, though large or bilateral perforations posed challenges.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Surgical Outcomes
Background:
- Tympanoplasty in pediatric patients remains a topic of debate.
- Type I tympanoplasty is a common surgical procedure for central tympanic membrane perforations.
Purpose of the Study:
- To evaluate the outcomes of type I tympanoplasty in children.
- To identify factors influencing the success rate of pediatric tympanoplasty.
Main Methods:
- A prospective study involving 45 children aged 5-14 years with central perforations.
- Surgery involved type I tympanoplasty using temporalis fascia autograft (underlay or overlay technique).
- Patients were evaluated one year post-operatively.
Main Results:
- The overall success rate for type I tympanoplasty was 91.1% at one year.
- Patient age did not significantly influence the success rate.
- Near total perforations and bilateral perforations were associated with lower success rates.
Conclusions:
- Type I tympanoplasty demonstrates a high success rate in children.
- The procedure is effective across different pediatric age groups.
- Careful patient selection is important, considering perforation size and laterality.
Abstract:
Considerable controversy surrounds the subject of tympanoplasty in children. This prospective study looked at the results of type-I tympanoplasty in children. Forty-five children in the age group of five to 14 years were selected for the study. All these cases had a central perforation without any evidence of cholesteatoma. The ear to be operated had to be dry for at least six weeks before surgery. Type I tympanoplasty was performed on these patients with autograft temporalis fascia by either the underlay or overlay technique. The overall success rates in 45 operations evaluated one year post-operatively was 91.1 per cent. The age of the patient had no influence on the success rate. The two factors which adversely influenced the success rate were the presence of near total perforation and bilateral perforations. It was concluded that type-I tympanoplasty has a good chance of success in children regardless of age.