An analysis of the results of myringoplasty in children

An analysis of the results of 100 temporalis fascia underlay myringoplasties in children between the ages of 2-17 years is presented. The follow-up period in this retrospective review was from 6 to 24 months. There was no statistically significant correlation between the age of patient, a history of previous ear surgery, previous general anaesthesia, previous adenotonsillar surgery, preoperative otorrhoea, impaired eustachian tubal function, individual surgeon performing the surgery, size of perforation or operative technique and the outcome of the surgery with respect to graft take rate. The overall graft take rate was 75.3% of the 93 patients that returned for follow-up. The seniority of the surgeon and by implication the degree of operative experience of the surgeon is found to be significantly correlated with the graft take rate (P < 0.05). On audiometric testing, the mean pre-operative air conduction threshold improved significantly (P < 0.0001) from 32.0 dBHL (S.D. 11.22) to 20.18 dBHL (S.D. 15.54) while the speech reception threshold improved from a mean of 25.34 dBHL (S.D. 12.88) to 18.79 (S.D. 15.5) (P < 0.0005). Although not statistically significant, patients under the age of 8 years were found to have a low graft take rate (56%) when compared to the mean. The audiometric results in this age group were comparable to the rest of the group. The findings in this study suggest that myringoplasty is a beneficial procedure in the pediatric population in the hands of a skilled and experienced surgeon. The learning curve seen in the surgeons in this study suggests that suitable cases for junior surgeons should be carefully selected.