Paediatric revision myringoplasty: outcomes and prospects

Paediatric revision myringoplasty has received little attention. This study addressed the issue exclusively and reviewed the short- and long-term results of surgery in children between the ages of five and 15. Twenty-six out of 38 operated ears (68.4 per cent) were initially intact. The causes of immediate failure in decreasing order were: infection with graft necrosis, complete no-take of the graft and poor anterior adaptation of the graft. Age, size and site of perforation and surgeon's experience did not significantly affect the initial outcome of surgery. Six ears developed delayed re-perforations, thus decreasing the overall sucess rate to 52.6 per cent. The latter were attributable to either episodes of acute otitis media or to insidious atrophy of the tympanic membrane. Notably, none developed post-operative sensorineural hearing loss. It is concluded that the results of paediatric revision myringoplasty are rather disappointing, yet arguments encouraging its practice are favourably presented.