Outcomes of Cartilage Tympanoplasty in Pediatric Patients

Abstract

Objective: To determine whether a relationship exists between successful outcomes of cartilage tympanoplasty and age at repair. Method: A retrospective chart review of patients between ages 4 and 13 who underwent cartilage tympanoplasty for tympanic membrane perforations from August 2005 to November 2011 was preformed. Demographics, complication data, and auditory outcomes were collected. Results: Patients were subdivided into 3 age groups. Group 1 consisted of patients less than 7 years of age (n = 43), group 2 ages 7 to 10 (n = 40), and group 3 ages 10 to 13 (n = 36). Mean follow-up was 595 days (range = 48-1742). Complication rates respective to the 3 groups were as follows: Eustachian tube dysfunction (ETD) or fluid causing a conductive hearing loss (9.3%, 10%, 5.6%), need for tympanostomy tubes (4.7%, 2.5%, 0%), remnant perforation (7%, 5%, 2.8%), and revision tympanoplasty (2.3%, 2.5%, 0%). Resolution of ETD or fluid on subsequent visits precluded tube placement. A 1-way analysis of variance (ANOVA) was performed to evaluate complication rates between groups. No significant differences were found (remnant perforation, P = .70, repeat tympanoplasty, P = .64, tympanostomy tubes, P = .42, and ETD or fluid, P = .76). Improvement in pure tone average was 10.23, 12.5, and 3.95, respectively. Conclusion: A trend for slight increase in complications in children under the age of 10 was found but was not statistically significant. There were significant group differences in hearing improvement with younger patients demonstrating better outcomes. The implications for these findings will be discussed. These data suggest cartilage tympanoplasty can be performed effectively in young children when appropriate conditions exist.