Stability of Tympanoplasty in Children

Paediatric tympanoplasty: comparative study between patients aged 5–8 years and those aged over 14 years

“…In general, most otologists tend to delay the closure of perforation in a child. It is reasoned that in view of unpredictable eustachian tube function, high frequency of otitis media and upper respiratory tract infections, and technical difficulties in the operation as a result of a narrow ear canal, this operation is best deferred in a child to as late as possible 15 – 17 …”

Results of type 1 tympanoplasty in children and parental perceptions of outcome of surgery

“…1 In addition, tympanoplasty has been suggested to protect against long-term middle-ear damage by preventing the progression of ossicular pathology and preventing the migration of squamous epithelium around the margins of the perforation with possible consequent cholesteatoma formation. 2,3 However, there are important differences between children and adults that make tympanoplasty in children a controversial issue. Children show a higher susceptibility to upper respiratory tract infections and eustachian tube dysfunction.…”

“…Children show a higher susceptibility to upper respiratory tract infections and eustachian tube dysfunction. 2,4 These factors have been held responsible by numerous authors for a decreased success rate for tympanoplasty in children. [5][6][7][8][9][10][11] In addition, the presence of a perforation may be bene cial to children with poor tubal function, by acting as a ventilating tube to provide ventilation to the middle ear.…”

“…[5][6][7][8][9][10][11] In addition, the presence of a perforation may be bene cial to children with poor tubal function, by acting as a ventilating tube to provide ventilation to the middle ear. 1,2,9,12 Closure of the perforation in such cases may lead to recurrent otitis media with effusion, or graft medialization or retraction, and may well negate any bene ts obtained. 2,5,13 Against this, other authors have reported excellent surgical success rates for tympanoplasty in chlidren.…”

“…1,2,9,12 Closure of the perforation in such cases may lead to recurrent otitis media with effusion, or graft medialization or retraction, and may well negate any bene ts obtained. 2,5,13 Against this, other authors have reported excellent surgical success rates for tympanoplasty in chlidren. 2,10,[14][15][16][17][18] It has also been suggested that diseased middle-ear mucosa prevents proper eustachian tube function and that normal function may only be restored with tympanic membrane closure which prevents re ux of nasopharyngeal secretions by restoration of the middle ear-mastoid air cushion.…”