Myringoplasty for pediatric chronic otitis media: An uncritical closure of a natural middle ear drainage?

Abstract

BackgroundPerforming tympanoplasty for tympanic perforations in children and adolescents is often considered to be less successful than in adults. ObjectivesThe aim of our study was to evaluate the surgical outcome of tympanoplasty type I in patients under 15 years of age with chronic otitis media and to identify potential factors that influence the success rate. Materials und methodsThe present study was based on a retrospective analysis of the medical records of all patients under the age of 15 who were treated for chronic otitis media by means of type I tympanoplasty between 2005 and 2020. The minimum follow-up period was 6 months. The data were analyzed with regard to epidemiological parameters, tube-related pathologies in the contralateral ear, the local condition and the extent of the eardrum perforation as well as the extent of the surgical intervention (tympanoplasty type I with or without adenotomy). Results83 cases were included in our study. The mean age at the time of the surgery was 8.9 years. The mean follow-up time was 46 months (6–182 months). The anatomical closure rate was 88.0%. Children with “dry” tympanic perforations tended to perform better (p = 0.052). The average improvement in the air bone gap was 2.0 dB. ConclusionDetailed preoperative counseling about the advantages and disadvantages as well as the expected success rate of an early myringoplasty in this age group is just as important as an individualized approach for a high level of patient satisfaction.