Adolescent Type 1 Cartilage Tympanoplasty: Factors Affecting Surgical Outcome

Area of Science:

• Otolaryngology
• Surgical Innovation
• Pediatric Surgery

Background:

• Tympanoplasty is a common surgical procedure to repair tympanic membrane perforations.
• Cartilage grafts offer durability and resistance to retraction, making them suitable for pediatric cases.
• Adolescent patients present unique challenges in tympanoplasty due to factors like Eustachian tube dysfunction.

Purpose of the Study:

• To assess the success rate of type 1 cartilage tympanoplasty in adolescents.
• To identify prognostic factors influencing surgical outcomes in this age group.

Main Methods:

• Retrospective review of 70 adolescent patients (84 ears) undergoing cartilage type 1 tympanoplasty (2018-2023).
• Analysis of demographic data, perforation characteristics, middle ear status, and prior surgical history.
• Evaluation of preoperative and postoperative hearing levels, anatomical, and functional success rates.

Main Results:

• Anatomical success rate was 83.3%; surgical success rate was 67.9%.
• Negative prognostic factors included adhesive otitis media (P<.001), previous ventilation tube insertion (P=.012), and larger perforation size (P=.046).
• No significant correlation found between success and age, gender, perforation type/location, or contralateral ear status.

Conclusions:

• Adolescent cartilage tympanoplasty demonstrates high success rates with meticulous surgical technique.
• Addressing adhesive otitis media, potentially with staged treatment, can improve outcomes.
• Cartilage is recommended as a graft material due to its superior durability and resistance to retraction in this population.