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Myringoplasty: is it worth performing in children?
1Department of Otolaryngology, City Hospital, Birmingham, England. umapathy3664@hotmail.com
Insights
Myringoplasty in children shows high success rates for eardrum closure and hearing improvement, comparable to adults. This procedure is safe and effective for pediatric patients with perforated eardrums.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Surgical Outcomes
Background:
- Myringoplasty is a common surgical procedure to repair tympanic membrane perforations.
- Evaluating outcomes in pediatric populations is crucial for establishing best practices.
Purpose of the Study:
- To assess the efficacy and safety of myringoplasty in children aged 4 to 14 years.
- To determine graft success rates and hearing improvement following the procedure.
Main Methods:
- Retrospective analysis of 89 myringoplasty cases in children (4-14 years old).
- Graft success defined by eardrum integrity at 12 months; hearing success by a 10 dB improvement.
- Exclusion of cases with concurrent mastoid exploration or inadequate follow-up.
Main Results:
- Eardrum closure achieved in 90% of cases, with 88% success after accounting for middle ear effusion.
- Hearing improved in 72% of patients, with no cases of profound hearing loss.
- Graft success and hearing outcomes were comparable to adult myringoplasty studies.
Conclusions:
- Myringoplasty demonstrates a high success rate in children, similar to adult outcomes.
- The procedure does not increase the incidence of middle ear effusion.
- Children undergoing myringoplasty can be safely managed with ventilation tubes.
Objective:
To evaluate the results of myringoplasty in children 4 to 14 years old at the time of surgery.
Design:
Retrospective analysis of case notes for 100 consecutive children who had myringoplasty in a teaching hospital serving as a primary care and referral center.
Methods:
Between March 1994 and March 1999, patients 14 years or younger at the time of surgery were identified by the computer database. There were 118 procedures performed in 100 patients (18 had a second procedure performed in the contralateral ear at a later date). Twenty-three patients were excluded because they underwent concurrent mastoid exploration, and 6 others because of inadequate follow-up, leaving 89 cases for analysis. Data from revision procedures were not included.
Main Outcome Measures:
Graft success was defined as an intact eardrum at 12 months postoperatively and middle ear effusion signaled graft failure. Success in terms of hearing was defined as an improvement in perception of pure-tone thresholds of 10 dB or greater over 2 consecutive frequencies compared with the results of the preoperative audiogram.
Results:
Closure of perforation was achieved in 90% (80) of patients, but dropped to 88% (78) as 2 patients developed glue ear. Hearing improved in 64 patients (72%), deteriorated in 7 (8%), and remained unchanged in 18 (20%). There was no case of profound hearing loss.
Conclusions:
The success rate of myringoplasty in children is comparable to that reported for adults. The incidence of middle ear effusion in grafted ears is not higher than that reported for nongrafted ears, and children who have had myringoplasty can be treated as safely with ventilation tubes as any other children.
