Reasons for reperforation after tympanoplasty in children

In 116 children and 124 ears with non-cholesteatomatous chronic otitis media operated on during a 13-year period from 1968 to 1980 via transcanal tympanoplasty and followed with several re-evaluations 15-27 years after operation, the causes of reperforation have been analysed. In total, 14 ears (11%) had reperformation; in 7 ears (5.6%), the reperforations occurred early (during the first 3 months) and in 7 ears late (after 6 months), but most often the reperforations occurred after 10 years. The early reperforations were presumably failures in surgery. Less experienced surgeons and inflamed, wet middle ear mucosa during the primary surgery seemed to be the two most important causal factors. Young age at surgery, size and site of the perforation and Eustachian tube function seemed to be of no importance for reperforation. The early reperforations were closed at surgery and remained closed into adulthood. The reasons for late reperforations are less clear; they were presumably caused by acute otitis media with perforation in an atrophic part of the drum, which did not heal. The reperforations were small, but it was possible to close all of them surgically if the patients wanted to be reoperated. It is concluded that tympanoplasty, even in young children, is a rewarding option with good and stable results.