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Myringoplasty in children: anatomical and functional results
L Pignataro1, L Grillo Della Berta, P Capaccio
1Dipartimento di Scienze Otorinolaringologiche Ospedale Maggiore I.R.C.C.S., 20122 Milano, Italy.
Insights
Myringoplasty in children shows an 80.5% success rate for uncomplicated eardrum perforations. A dry ear pre-surgery is key for successful outcomes, improving hearing by 11 dB.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Audiology
Background:
- Tympanic membrane perforations are common in children.
- Myringoplasty aims to repair these perforations, restoring hearing and middle ear function.
- Factors influencing pediatric myringoplasty outcomes require further elucidation.
Purpose of the Study:
- To evaluate the anatomical and functional results of myringoplasty in children.
- To identify factors predicting successful surgical outcomes in pediatric patients.
Main Methods:
- Retrospective analysis of 41 myringoplasties in children with uncomplicated perforations.
- Exclusion of cases requiring ossiculoplasty or mastoidectomy.
- Assessment of anatomical success, audiological improvement (air conduction threshold), and influencing factors.
Main Results:
- Overall success rate of 80.5% after a mean follow-up of 39 months.
- Significant audiological improvement of 11 dB in successful cases (p<0.05).
- A dry ear at surgery strongly correlated with good outcomes (p<0.01); age, perforation characteristics, and surgical technique did not significantly impact results.
Conclusions:
- Myringoplasty is an effective procedure for pediatric eardrum perforations, yielding good anatomical and functional results.
- Maintaining a dry middle ear environment pre-operatively is crucial for optimizing surgical success.
- Pre-operative evaluation and management of middle ear inflammatory conditions are recommended.
Abstract:
To assess the results of myringoplasty in children and determine the factors influencing post-operative results a retrospective study of the anatomical and functional results of 41 myringoplasties in children was performed, considering only the cases of uncomplicated perforation that did not require ossiculoplasty or mastoidectomy. The overall success rate was 80.5 per cent after a mean follow-up of 39 months. The mean post-operative air conduction threshold significantly improved in the successful cases with a mean audiological improvement of 11 dB (p<0.05). No post-operative sensorineural hearing loss was observed. There was a significant statistical association between the presence of a dry ear at the time of surgery and good surgical results (p<0.01). Surgical outcome was not affected by the patient's age, the site and size of the perforation, previous adenoidectomy, surgical technique (overlay vs underlay), or the status of the contralateral ear. Our findings suggest that myringoplasty is a valid procedure in the paediatric population that gives good anatomical and functional results. The status of the middle ear (i.e. the presence of a dry ear), significantly improves surgical outcome; and so careful inflammatory changes in the middle-ear mucosa should be evaluated and medical treatment considered before surgery.