Effects of mastoid and middle-ear volume on graft success and hearing outcomes in paediatric tympanoplasty

Abstract

Objective To examine the effects of mastoid and middle-ear volume on the anatomical and functional success of type 1 tympanoplasty in paediatric patients. Methods This study included 45 paediatric patients who underwent type 1 cartilage tympanoplasty. Patients’ demographic data, pre- and post-operative audiological evaluation results, and post-operative graft status were evaluated. Middle-ear and mastoid cavity volumes were calculated (in cubic centimetres) using temporal bone high-resolution computed tomography. Middle-ear and mastoid cavity volume values were compared between patients with and without post-operative anatomical and functional success. Results Anatomical success was achieved in 82.2 per cent of patients (n = 37), and functional success in 68.9 per cent (n = 31). When anatomical success and failure groups were compared, a statistically significant difference was found in mean mastoid volume (p = 0.037), while there was no significant difference in relation to mean middle-ear volume (p = 0.827). The comparison of functional success and failure groups revealed no significant difference in mean mastoid volume (p = 0.492) or middle-ear volume (p = 0.941). Conclusion The study showed that mastoid pneumatisation volume affects surgical success in paediatric tympanoplasty.

The Age-Related Growth of Mastoid Air Cells in Infancy: A Retrospective Cross-Sectional Study

“…When planning middle ear surgery, including cochlear implantation, facial nerve decompression, ossiculoplasty, and tympanoplasty, among others (17), it is necessary to consider the size and growth of the mastoid air cells. The poor results of tympanoplasty in children may be due to immature mastoids (18,19). In addition, it has been reported that the degree of mastoid pneumatization is related to the degree of nasal septal deviation, eustachian tube length, tinnitus, presbycusis, cholesteatoma, cystic fibrosis, and other unknown conditions (20)(21)(22)(23).…”

An inter-observer assessment of mastoid pneumatization and degree classification using sigmoid sinus: comparing two levels of temporal bone computed tomograms

“…Increased pneumatization of the temporal bone is associated with an improved prognosis in otitis media with effusion (OME) [ 13 ], as well as higher tympanoplasty graft success rates [ 14 ]. It is also relevant to surgical planning for bone conduction implants, active middle ear implants, and even cochlear implantation when assessing the space required for implant placement or predicting access to the middle ear via trans-mastoid, retro-facial approaches [ 15 ].…”

Pneumatization of the temporal bone, its petromastoid part and related vasculature in a South African population from early childhood to early adulthood: an anatomical and radiological study.

“…Furthermore, temporal bone pneumatization positively correlates with the risk of OM with effusion and tympanoplasty success rates (Sade & Fuchs, 1997;Baklaci et al, 2022). It could also give favorable positioning of related vasculatures, such as the SS and JB, that could become pitfalls for surgeons (Friedman et al, 2010;.…”