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Pediatric tympanoplasty: A paradigm shift?
Joana A S Marques1, Mafalda Sousa1, Laurentino Mendes Leal1
1Department of Otorhinolaryngology - Centro Hospitalar Universitário São João, EPE, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal; Unit of Otorhinolaryngology - Department of Surgery and Physiology - Faculty of Medicine, University of Porto, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal.
Insights
Pediatric tympanoplasty effectively repairs chronic tympanic perforations in children. Factors like age and surgical approach did not significantly impact graft success in this study.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Otic Surgery
Background:
- Pediatric tympanoplasty outcomes are debated.
- Factors influencing success include age, perforation characteristics, and Eustachian tube function.
Purpose of the Study:
- Evaluate pediatric tympanoplasty outcomes.
- Analyze factors affecting surgical success in children.
Main Methods:
- Retrospective review of 83 children (5-15 years) undergoing tympanoplasty.
- Exclusion of cases with cholesteatoma or simultaneous mastoidectomy.
- Comparison of outcomes based on age groups and perforation characteristics.
Main Results:
- Successful tympanic membrane closure in 76.9% of primary and 55.6% of revision surgeries.
- Improved conductive hearing reported in most patients.
- Anterior perforations showed a higher risk for revision surgery.
Conclusions:
- Pediatric tympanoplasty is an effective treatment for chronic tympanic perforations.
- Age and surgical approach were not significant predictors of graft failure in this cohort.
Introduction And Objectives:
Pediatric tympanoplasty is still a matter of controversy. Many factors have been associated with the surgical outcome of tympanoplasty in children, including age, size and location of the perforation, surgical technique and Eustachian tube dysfunction. The optimal approach and timing of this surgery remains controversial. This study aims to evaluate the outcomes of pediatric tympanoplasty and analyze factors that may influence the success of this surgery.
Materials And Methods:
A retrospective review was conducted which included children from 5 to 15 years old that underwent tympanoplasty with or without ossiculoplasty for chronic tympanic perforation in a tertiary care university hospital over a 6-year period. Patients were divided in two age groups (5 to ≤10 years old and >10 to 15 years old). Children with cholesteatoma or that underwent simultaneous mastoidectomy were excluded.
Results:
83 cases were included. Average age was 10.7±2.1 years and mean follow-up time was 9 months. Of the cases, 21.7% were revision surgeries. Successful closure of the tympanic membrane perforation was achieved in 76.9% of primary surgeries and 55.6% of revision surgeries. Most of the patients improved their conductive hearing-deficit. No statistical difference in graft failure was noted regarding age, presence of craniofacial dysmorphism and surgical approach. The use of simple graft (temporal muscle fascia or tragus perichondrium) was significantly superior in primary surgery (p<0.05). We also found a significant difference between the location of the perforation and revision surgery, with anterior perforations showing a higher risk (p<0.05).
Conclusions:
Pediatric tympanoplasty is effective in repairing chronic tympanic perforations. In our study, accepted predictors of surgical outcome such as age and surgical approach were not associated with graft failure.
