The significance of selected prognostic factors in pediatric tympanoplasty

Abstract

The aim of this study was to determine the importance of selected prognostic factors on outcomes of tympanoplasty in children. 241 children classified into three age groups (3-7, 8-12 and 13-18), had undergone tympanoplasty between 2001 and 2007 and were subsequently observed for at least 2years. Prognostic factors were assessed with regard to their impact on the functional and anatomical outcome of the tympanoplasty defined, respectively, as postoperative air-bone gap and state of the middle ear. In 85% of children, a tympanic membrane reconstruction was performed. An unchanged TM was achieved in 85% of the patients in early results and in 76% in later results. Air-bone gap closure was observed in 66% of cases. The earlier preventive retraction pocket tympanoplasty was performed, the better anatomical results were obtained-ranging from 91% in the 3-7 age group versus 75-70% in 8-12 and 13-18 age groups. The results of total or subtotal perforation reconstructions were worse than for small perforation with closure rates of 76.5% vs 94.5%, respectively. Age is not a factor determining the success rate in pediatric tympanoplasty. A better surgical outcome can be achieved in children with a dry ear, and better middle ear condition, because of previously performed surgeries. Preventive tympanoplasty is also advantageous. The hearing results in type 2 and 3 tympanoplasty are similar, but type 1 tympanoplasty has superior efficacy to the former two types.