Pediatric myringoplasty: surgical outcomes of postauricular temporalis fascia graft versus permeatal tragal perichondrial graft in the management of tympanic membrane perforations

Abstract

Objective The aim of this study was to investigate the difference in success rate between temporalis fascia graft and tragal perichondrial graft among pediatric patients undergoing tympanoplasty type 1 for chronic suppurative otitis media with dry central perforation. Background Chronic otitis media surgery is the most common procedure in otology in developing countries. Many surgical options with graft materials are used for closure of the tympanic membrane perforations. Patients and methods This is a prospective randomized comparative study including 54 pediatric patients (56 ears), between 8 and 18 years of age, with tympanic membrane perforation. Patients were randomly divided into two groups: group A included 30 ears of 28 patients who were subjected to postaural temporalis fascia graft myringoplasty and group B included 26 ears of 26 patients who were subjected to permeatal tragal perichondrial graft myringoplasty. Closure of the perforation within 1 year postoperatively and improvement in hearing with air-bone gap on pure tone audiogram less than 10 dB were considered as success criteria. Sex, age, site and size of perforation, and status of contralateral ear were studied. Results The overall success of tympanic membrane perforation closure was 86.7% in group A and 88.4% in group B, with no statistically significant difference between the two groups. No difference was found as regards sex and site of perforation between the two groups. However, bilateral ear affection and the size of perforation had a significant difference in overall success. Moreover, no significant audiological difference was found between the two groups, but the overall improvement was significant. Conclusion Tympanoplasty type 1 (myringoplasty) is an appropriate technique for repairing tympanic membrane perforation in pediatric patients. Both postaural temporalis fascia graft and permeatal tragal perichondrial graft are effective, with no significant difference between the two techniques. Bilateral affection of the ears and size of perforation should be considered as determinant factors for success.