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Tympanic Perforations in Children: When to Propose Surgical Closure?
Marine Del Puppo1, Anne Farinetti, Stéphane Roman
1Department of Pediatric Otolaryngology Head and Neck Surgery, La Timone Children's Hospital, AP-HM, Aix Marseille Université, Marseille, France.
Insights
Myringoplasty in children shows high success rates for tympanic closure and improved hearing. Age is not a barrier to successful myringoplasty in pediatric patients.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Surgical Outcomes
Background:
- Tympanic membrane perforations are common in children.
- Myringoplasty is a surgical procedure to repair these perforations.
- Understanding prognostic factors is crucial for optimizing surgical success.
Purpose of the Study:
- To evaluate the success rates of myringoplasty in children.
- To analyze the impact of patient age on myringoplasty outcomes.
- To identify other prognostic factors influencing surgical results.
Main Methods:
- Retrospective case series of 241 children (318 ears) aged 3-17 years.
- Myringoplasty performed between 2009 and 2019.
- Data collected on tympanic closure, recurrence, reoperation, and audiometric gain.
Main Results:
- High tympanic closure rate (87.7%) and significant audiometric improvement (mean ABG decrease from 21 dB to 12 dB).
- No significant difference in outcomes based on age groups.
- Audiometric results correlated with perforation location, middle ear inflammation, and surgical technique.
Conclusions:
- Myringoplasty in children yields excellent anatomical and functional results across all age groups.
- Patient selection is key for successful myringoplasty in pediatric populations.
- The procedure is recommended for well-selected children regardless of age.
Objective:
This study aims to analyze the impact of age and other prognostic factors on the success of myringoplasty.
Study Design:
A retrospective case series.
Settings:
Pediatric ENT department of a tertiary academic center.
Patients:
Two hundred forty-one children (318 ears) aged 3 to 17 years with tympanic perforation.
Intervention:
Myringoplasty performed between 2009 and 2019.
Main Outcomes Measures:
The rate of tympanic closure, perforation recurrence, revision surgery, and audiometric gain were collected. The impact of age and anatomical and surgical factors was analyzed for each procedure.
Results:
With a mean follow-up time of 1 year, the tympanic closure rate was 87.7%, the perforation recurrence rate was 18.6%, and 16.7% of ears required reoperation. The mean air-bone gap decreased from 21 dB preoperatively to 12 dB postoperatively ( p < 0.0001). We did not find different anatomical and audiometric results for our three groups of patients classified according to age. Audiometric results were associated with the location of the perforation, intraoperative inflammation of the middle ear mucosa, and the surgical technique performed.
Conclusion:
Myringoplasty in children is associated with excellent anatomical and functional results, even in the youngest patients. It can be proposed whatever the child's age if the patients are well selected before giving the indication.
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