Predictors of anatomical and functional success in pediatric type I tympanoplasty
D Cunha-Cabral1, P Marques Gomes2, A I Gonçalves3
1Department of Otorhinolaryngology, Unidade Local de Saúde de Matosinhos, Hospital Pedro-Hispano, Porto, Portugal; Unit of Anatomy, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal.
Insights
Predictors for successful pediatric tympanoplasty include perforation etiology and tympanosclerosis. Larger perforations may lead to poorer hearing outcomes after type I tympanoplasty surgery.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Audiology
Background:
- Type I tympanoplasty is a common surgical procedure for pediatric eardrum perforations.
- Predicting anatomical and functional success is crucial for optimizing patient outcomes.
Purpose of the Study:
- To identify predictors of anatomical and functional success in pediatric type I tympanoplasty.
- To evaluate the impact of perforation etiology and tympanosclerosis on surgical outcomes.
Main Methods:
- A retrospective case-control study of 79 pediatric ears undergoing type I tympanoplasty (2012-2022).
- Anatomical success assessed at 6, 12, and final follow-up.
- Functional success defined by postoperative air-bone gap (ABG) <10dB.
Main Results:
- Anatomical success rates were 88.6% (6 months), 83.5% (12 months), and 77.2% (final follow-up).
- Perforation etiology (traumatic/post-tube vs. chronic otitis media) and tympanosclerosis predicted anatomical success.
- Larger perforations (>50% TM area) correlated with worse functional outcomes (ABG).
Conclusions:
- Pediatric type I tympanoplasty demonstrates favorable anatomical and functional results.
- Perforation cause and tympanosclerosis presence are key predictors of anatomical success.
- Large eardrum perforations may indicate poorer postoperative hearing results.
Aims:
Identification of predictors of anatomical and functional success in pediatric type I tympanoplasty.
Material And Methods:
In this case control study, we reviewed the medical records of children undergoing type I tympanoplasty between January 2012 and December 2022 in our hospital. Anatomical success was evaluated at 6 (T1), 12 (T2) months and at the end of follow up (T3). Functional success was defined as a mean postoperative ABG<10dB in ears with sustained tympanic membrane integrity.
Results:
A total of 79 ears (67 patients) were included. The median age of our sample was 12 years (range, 8-17), and the median follow-up period was 27 months (range, 12-86). The anatomical success rates at T1, T2, and T3 were 88.6%, 83.5%, and 77.2%, respectively. The etiology of the perforation was an independent predictor of anatomical success at T2 and T3. Patients with traumatic or post-ventilation tube perforations were less likely to experience reperforation compared with those with chronic otitis media (P=0.023 and P=0.009, respectively). The presence of tympanosclerosis was an independent predictor of reperforation at T1, T2, and T3. The mean postoperative ABG was 6.45±0.91dB HL. Larger tympanic membrane perforations (>50% of the total TM area) had significant worse functional outcomes (P=0.021).
Conclusion:
Type I tympanoplasty has good anatomical and functional outcomes in the pediatric age. The etiology of the perforation and the presence of tympanosclerosis may be used as predictors of anatomical success. Larger perforations may predict worse postoperative audiometric outcomes.
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