Abstract
BackgroundThe aim of this study was to investigate the success of type 1 tympanoplasty in pediatric patients with chronic otitis media, and to evaluate the prognostic factors that may influence its success.Materials and methodsMedical records of 102 children aged between 8 and 18 years (46 female, 56 male) who underwent type 1 tympanoplasty for chronic tympanic membrane perforation between January 2010 and July 2017 were reviewed. Age, gender, condition of contralateral ear (unilateral, bilateral), type (central, marginal) and location of perforation (anterior, posterior, inferior), graft material (fascia, cartilage), pre- and post-operative hearing levels, mean air-bone gap (ABG), surgical approach (postauricular, endaural) and length of follow up were recorded.ResultsAnatomical and functional success (ABG < 20 dBHL) rates were 86.3% (88 patients) and 74.5% (76 patients) after a mean follow-up of 32 ± 16.55 months, respectively. The mean hearing improvement was 10.77 ± 10.45 dBHL. The graft success rates were significantly higher in tragal cartilage group (95.1%) than in temporalis fascia group (80.3%) (p = 0.033). Graft success was negatively affected by contralateral perforation (p = 0.003). All patients with bilateral perforations and graft failure were in temporalis fascia group. Age, type and location of perforation and surgical approach did not influence graft success (p > 0.05).ConclusionOur results showed that type 1 tympanoplasty can be performed effectively in pediatric population regardless of age, location and type of perforation and surgical approach. Bilateral perforations are prone to reperforation, and should be treated with cartilage graft.
Highlights
The aim of this study was to investigate the success of type 1 tympanoplasty in pediatric patients with chronic otitis media, and to evaluate the prognostic factors that may influence its success
We aimed to investigate the surgical and functional outcomes of type 1 tympanoplasty in pediatric population and determine the factors influencing the success of tympanoplasty
Prior written informed consent was obtained from the parents or guardians of the children who served as participants, and of participants 16 years or older, and assent form participants under 16 years of age
Summary
The aim of this study was to investigate the success of type 1 tympanoplasty in pediatric patients with chronic otitis media, and to evaluate the prognostic factors that may influence its success. The success rate of tympanoplasty still remains a considerable interest. A success rate of tympanoplasties in children ranging from 35 to 94% [4, 5]. Numerous factors have been proposed for the reason of poorer tympanoplasty outcomes in children than in adults: higher frequency of upper respiratory infection and otitis media, poorer eustachian tube function and presence of hypertrophic adenoid tissue, and immaturity of the immune system [6,7,8,9,10]. Some authors do not propose tympanoplasty in pediatric age [10, 11].
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