Pediatric tympanoplasty: factors affecting success

Objectives: There is a marked diversity in the reported success rates for achieving an intact tympanic membrane following tympanoplasty. Controversy exists about the factors thought to influence surgical outcome. These facts have important implications for the selection of patients who would benefit the most. This study reviews the factors thought to determine the anatomical and functional success of tympanoplasty in children. Materials and methods: Retrospective study of the anatomical and functional results of 91 tympanoplasties performed in children. Age, gender, size and site of perforation, status of operated and contralateral ear, underlying cause of the perforations, surgical technique, preoperative and post-operative hearing levels, post-operative follow-up time and post-operative complications were recorded. We divided our population into two groups according to the expected eustachian tube maturity (younger group (N = 24): 10 years old, older group (N = 67): >10 years old). All patients were evaluated in terms of anatomical and functional outcome and complications. Results: Anatomical success was achieved in 85.7% and functional success was 76.9% after a mean follow-up of 25.6 AE 17.1 months. Anatomical success (intact tympanic membrane) was achieved in 83% of younger vs 87% of older patients ( p = n.s.). Functional (air bone gap closure) success was 75% in the younger group vs 78% in the older group ( p = n.s.). There were no significant differences in post-operative gain at different frequencies (500, 1000, 2000 and 3000 Hz) between the two groups. A previous adenoidectomy in children older than 10 years seems to be an independent predictor of functional success The incidence of minor and major complications were 29% in patients aged 10 and 21% in those older than 10 ( p = n.s.). We report 12.9% minor post-operative complications in successful cases: injury to the chorda tympani nerve (5.7%), wound infection (2.9%), otitis externa (2.9%) and transient vertigo (1.4%). Among the 21 reperforations observed, 92.3% occurred before 1 year. Conclusions: This study shows that tympanoplasty is a valid treatment modality for tympanic membrane perforation in the pediatric population. A tympanic membrane perforation can be closed at any age. There is no age limit below which perforation should not be closed. A previous adenoidectomy in children older than 10 years seems to be an independent predictor of functional success. #

show abstract

“…Age is often cited as a key prognostic factor in evaluation for tympanoplasty in children [15,19,22,23].…”

Section: Discussionmentioning

confidence: 99%

Tympanoplasty in children: A review of 91 cases

Ribeiro¹,

Cerejeira²,

Silvestre³

et al. 2011

Auris Nasus Larynx

View full text Add to dashboard Cite

show abstract

“…Pediatric tympanoplasty is one of the most commonly performed procedures by surgeons; different success rates have been reported, ranging between 35% and 94% [1] . Eustachian tube dysfunction can worsen the condition of the operated ear during the postoperative period.…”

Section: Introductionmentioning

confidence: 99%

“…This known but unproven fact has encouraged surgeons to use cartilage material in tympanoplasty procedures, especially for bilateral cases. Cartilage material has strong mechanical endurance and resistance to infection under negative pressure changes inside the middle ear [1][2][3][4] . Some surgeons have reported superior results using cartilage grafting in patients with bilateral chronic otitis media, which is an indicator of poor eustachian tube function [3,4] .…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Cartilage Palisades and Temporal Fascia in Type 1 Tympanoplasty for Bilateral Tympanic Membrane Perforations in Children

Gün

Boztepe²,

Atan³

et al. 2017

Int Adv Otol

View full text Add to dashboard Cite

OBJECTIVE:To compare the graft success rates and audiological outcomes of bilaterally performed type 1 tympanoplasty using cartilage palisades or temporal fascia in children. MATERIALS and METHODS:We retrospectively analyzed the medical records of patients who underwent type 1 tympanoplasty at Medical Park Hospital between May 2007 and February 2013. 27 patients (54 ears) were enrolled in the study: 15 (30 ears) in the palisade cartilage group and 12 (24 ears) in the fascia group. RESULTS:The graft success rate for the fascia group was 79.2%, and that for the cartilage group was 96.7%. The difference was statistically insignificant (p=0.078). Audiological improvements were seen in both groups, and the difference was statistically insignificant. CONCLUSION:The use of temporalis fascia grafting has similar outcomes to palisade cartilage tympanoplasty for both success rate and audiological values in children who have bilateral disease.

show abstract

“…In the literature, various tympanoplasty techniques and graft materials have been described so far (6,7). Each technique has some advantages and disadvantages.…”

Section: Discussionmentioning

confidence: 99%

Anatomic and Functional Results of Cartilage Type 1 Tympanoplasty in Children and the Evaluation of the Success of Surgery with Parental Perceptions

Yılmaz¹,

Güven²,

Kayabaşoğlu³

et al. 2014

Turk Arch Otolaryngol

View full text Add to dashboard Cite

Objective: This study aims to determine the anatomic and functional results of cartilage Type 1 tympanoplasty in children and to evaluate the success of surgery with parental perceptions. Methods:Only pediatric patients who had undergone cartilage Type 1 tympanoplasty were included in this study. Patients older than 16 years and patients who had otorrhoea during the previous month, chronic otitis media with cholesteatoma and patients who had undergone mastoidectomy or ossiculopasty were excluded. The 'anatomical' success was accepted as an intact graft in the last control in the at least 6 th month postoperatively. A satisfaction questionnaire with four questions about the perceptual results of surgical intervention was applied to the patients' parents on the telephone. Results:In total, 44 ears of 41 cases (22 male 19 female) were included in the study. The mean age was 13.2±2.7 (8-16) and the mean follow-up time was 17 (7-36) months. Anatomical success rate was 88.6% (39/44). As a preoperative mean, the pure tone hearing threshold was 30.7±7.7 dB and the postoperative mean pure-tone hearing threshold was 18.8±7.8 dB. Among the operated ears, 88.6% (39/44) of the perforations were treated successfully. Of the 41 paediatric patients' parents, only 28 (68.2%) could be reached by telephone; nineteen (68%) of the 28 parents contacted thought that the hearing level had improved postoperatively and only 10 parents (35%) stated that his/her child could attend a preoperatively-restricted activity postoperatively. Conclusion:Outcomes of cartilage tympanoplasty in children satisfy both surgeons and parents. Chronic otitis media in children must be managed with surgery as soon as favourable conditions are provided.

show abstract

Pediatric tympanoplasty: factors affecting success

Cited by 54 publications

References 29 publications

Tympanoplasty in children: A review of 91 cases

Tympanoplasty in children: A review of 91 cases

A Comparison of Cartilage Palisades and Temporal Fascia in Type 1 Tympanoplasty for Bilateral Tympanic Membrane Perforations in Children

Anatomic and Functional Results of Cartilage Type 1 Tympanoplasty in Children and the Evaluation of the Success of Surgery with Parental Perceptions

Contact Info

Product

Resources

About