Factors influencing cartilage tympanic perforation repair in children.

Abstract

Objectives: The aim of the study was to identify factors that could influence the repair of eardrum perforation using cartilage graft (or cartilage tympanoplasty) in children. Methods: A cohort of children operated on between January 1998 and December 2012 was reviewed. We have studied the repair rate of the eardrum (anatomical result) and the hearing level with audiometric tests (functional result) at 1 year and 3 years after surgery. These results were correlated with size or location of the perforation, status of the contralateral ear, gender, allergies, cleft palate, craniofacial anomalies, expertise of the surgeon (junior, senior) and perioperative observations (mucosa, glue, etc.). Results: 1240 tympanoplasties were selected from the database, of which 139 ears (127 patients) could be analysed (perforation without concurrent disease, authorisation from patients obtained and sufficient information reported). Mean age at surgery was 9.6 years ± 2.6 (range 4-16). At one year, 129/139 (93%) tympanic membranes were closed and 112/139 (81%) were satisfactory (no residual perforation, nor retraction, cholesteatoma, myringitis or OME). Air-bone gap was < 20 dB in 102/127 ears (80%). At 3 years, the eardrum was closed in 64/66 (97%) ears (reperforation in one case) and 82% were satisfactory. Myringitis occurred in 5% and 9% of cases at one- and three-year follow-up. Surgery before the age of 8 years was the only risk factor of a non-satisfactory result at one-year follow-up (p = 0.024). Conclusions: Long-term results were satisfactory; the only risk factor was surgery before eight years of age. In the child, long-term yearly follow-up is necessary after tympanic perforation.