Postoperative Anatomical and Functional Success Rates of Pediatric Patients with Chronic Otitis Media: Our Experiences
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Published on: May 23, 2021
Duygu Erdem1, Deniz Baklaci1, Sultan Sevik Elicora1
1School of Medicine, Department of Otorhinolaryngology, Bulent Ecevit University, 931st Avenue 945 Street No:5/3, Ilker, Ankara Zonguldak, Turkey.
Insights
This study evaluated chronic otitis media surgery in pediatric patients, finding that disease type and contralateral ear status impact graft success. Preoperative assessment considering these factors is crucial for informed parental consent and optimal outcomes.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Audiology
Background:
- Chronic otitis media surgery in pediatric patients aims to improve hearing and anatomical outcomes.
- Factors influencing surgical success, including disease type, surgical technique, and graft material, require thorough investigation.
Purpose of the Study:
- To evaluate preoperative and postoperative hearing thresholds and anatomical graft success in pediatric patients undergoing chronic otitis media surgery.
- To identify factors affecting surgical success, including age, disease type, surgical approach, contralateral ear status, and graft material.
Main Methods:
- Retrospective analysis of pediatric patients (6-18 years) who underwent ear surgery between 2013-2020.
- Assessment of pure-tone hearing thresholds, hearing gains, and anatomical/functional graft success at six months post-surgery.
- Evaluation of factors: age, disease type (cholesteatoma, tympanosclerosis, etc.), surgery type, contralateral ear condition, and graft material (temporal fascia/tragal cartilage).
Main Results:
- No significant difference in anatomical or functional graft success based on surgery type or disease type.
- No significant difference in graft success between temporal muscle fascia and conchal cartilage grafts.
- A statistically significant difference in functional success was observed based on the presence of contralateral ear disease (p=0.014), with a trend towards decreased anatomical success in these cases (p=0.188). Age did not significantly impact graft success.
Conclusions:
- Disease type, contralateral ear status, and graft material significantly influence functional and anatomical graft success rates in pediatric chronic otitis media surgery.
- Preoperative evaluation should consider these factors to inform surgical planning and patient counseling.
- Informed consent discussions with parents must address potential postoperative conditions related to these influencing factors.
Abstract:
The preoperative and postoperative pure-tone hearing thresholds and anatomical graft success of pediatric patients who underwent chronic otitis mediasurgery with various indications were evaluated and the factors affecting success were examined.Pediatric patients aged 6 to 18 years, who underwent ear surgery for various reasons between January 1, 2013 and January 1, 2020 were included in the study. All patients included in the sample were assessed in terms of age (< 13 and ≥ 13 years), disease type (cholesteatoma, tympanosclerosis, adhesive otitis media, chronic suppurative otitis media, isolated or traumatic tympanic membrane perforation), surgery performed (type 1 tympanoplasty, canal wall-up mastoidectomy, and exploratory tympanotomy), condition of the contralateral ear (unilateral/bilateral disease), graft material (temporal muscle fascia/tragal cartilage), preoperative and postoperative pure-tone audiometry thresholds and hearing gains, and postoperative sixth-month functional and anatomical graft success. Anatomical graft success and functional success were also evaluated according to the type of surgery performed, type of disease, type of fascia used in surgery, condition of the contralateral ear, and age. No statistically significant difference was found between the groups in terms of anatomical graft success and functional success according to the type of surgery performed (p = 0.414 and p = 0.123, respectively) and type of disease (p = 0.454 and p = 0.097, respectively). There was also no statistically significant difference between the anatomical and functional success of temporal muscle fascia and conchal cartilage grafts (p = 0.833 and p = 0.565, respectively). While no statistically significant difference was observed in graft success between the patients with and without contralateral ear disease, there was a statistically significant difference in functional success (p = 0.188 and p = 0.014, respectively). Although not statistically significant, it was observed that the anatomical graft success rates were decreased in patients with contralateral ear disease compared to those without bilateral disease (p = 0.188). There was no significant difference between age and anatomical graft success (p = 0.865) or functional success (p = 0.956). The type of disease in the diagnosed ear, presence of disease in the contralateral ear, and graft material used affect functional and anatomical graft success rates. Therefore, we believe that pediatric patients should be evaluated considering these factors in the preoperative period and the parents of these patients should be well informed about possible postoperative conditions.
