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Retrospective long-term analysis of tympanoplasty in children
Osikhe Ejeah-Braimoh1, Bastian Baselt1, Christof Röösli1
1Universitätsspital Zürich, Klinik für Ohren-, Nasen-, Hals- und Gesichtschirurgie, Frauenklinikstrasse 24, 8091, Zurich, Switzerland.
Insights
Pediatric tympanoplasty shows moderate long-term success, with perforation size and cause being key factors. Age is less influential than previously thought for surgical outcomes.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Auditory Health
Background:
- Tympanoplasty is a surgical procedure to repair tympanic membrane perforations (TMP) in children.
- Long-term outcomes and prognostic factors for pediatric tympanoplasty are not fully understood.
- This study investigates anatomical and functional results of pediatric tympanoplasty over five years.
Purpose of the Study:
- To evaluate the anatomical and functional outcomes of pediatric tympanoplasty.
- To assess the influence of patient age and other prognostic factors on surgical success.
- To provide insights into optimizing surgical timing and patient selection for pediatric tympanoplasty.
Main Methods:
- Retrospective single-center cohort study of pediatric patients (≤16 years) undergoing tympanoplasty for TMP.
- Data collected from electronic hospital records, including operative reports and audiometric evaluations.
- Analysis of anatomical success (intact tympanic membrane) and functional success (air-bone gap <20 dB) over a five-year follow-up.
Main Results:
- Overall five-year anatomical success rate was 57.9%, and functional success was 69.4%.
- No consistent correlation between age and long-term outcomes was found, though older children had better functional success at 12 months.
- Perforation size and etiology significantly influenced success rates, with smaller, infection-related perforations faring better.
Conclusions:
- Pediatric tympanoplasty yields favorable functional outcomes and moderate long-term anatomical success.
- Age is not a primary determinant of surgical success; clinical factors are more significant.
- Perforation characteristics (size, location, etiology) are crucial prognostic indicators for tympanoplasty outcomes in children.
Objective:
Tympanoplasty is a well-established surgical intervention for tympanic membrane perforation (TMP) in children, aiming to restore anatomical integrity and improve auditory function. However, long-term outcomes remain variable, and factors influencing surgical success are still debated. This study evaluates anatomical and functional outcomes of pediatric tympanoplasty over a five-year follow-up period, with a particular focus on the influence of age and other prognostic factors.
Methods:
A retrospective single-center cohort study was conducted at a tertiary referral hospital, including pediatric patients (≤16 years) who underwent tympanoplasty for TMP between January 01, 2012 and December 31, 2022. Data were retrieved from electronic hospital records, including operative reports, audiometric evaluations, and follow-up documentation. Primary outcomes were anatomical success (intact tympanic membrane at follow-up) and functional success (air-bone gap <20 dB). Secondary outcomes included postoperative complications and factors influencing surgical success.
Results:
A total of 111 ears (96 patients) were analyzed, with a mean follow-up of 17.9 months (range 3-60 months). The overall anatomical success rate at five years was 57.9 % and functional success at five years was 69.4 %. No significant correlation between age and anatomical or functional outcomes was found, except at 12-months-follow-up, there was a statistically significant advantage for older patients in functional success. Perforation size and etiology significantly impacted success rates, with smaller and infection-related perforations demonstrating better outcomes.
Conclusion:
Tympanoplasty in children can result in favorable functional outcomes and moderate long-term anatomical success. No consistent age-related effect was observed, suggesting that surgical timing should be based on individual clinical factors rather than age alone. Perforation size and location as well as etiology emerged as more relevant prognostic factors. Future prospective multicenter studies are needed to validate these findings and guide patient selection.
