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Objectives: To evaluate the success rates of myringoplasty in
children and to identify factors that could influence the surgical
outcome.
Methods: Myringoplasties performed on 55 children during the
years 2000-2005 with at least 18 months follow-up period were
retrospectively reviewed. The mean age of the patients was 12.4 (range
8-16 years). Surgical success was defined as having an intact, mobile
graft without atelectasis and having an air-bone gap under 20 dB after
18 months postoperatively. Factors that could influence the surgical
outcome such as age, status of the opposite ear, perforation size and
experience of the surgeon were also investigated.
Results: The overall graft success rate 18 months postoperatively
was 72.7%. The mean values of preoperative and postoperative air-bone
gaps were 26.4±2.6 dB vs 10.5±9.2 dB respectively. This result was
statistically significant (p<0.001). Perforation size greater than 75%
of the tympanic membrane area was found to be a negative prognostic
factor (p=0.023). The success rates were also found to be low in younger
children with pathologic contralateral ear although the results were not
in the range of significance.
Conclusion: Myringoplasty in children gives good anatomic and
functional results. However, one must always keep in mind that the
patient evaluation preoperatively is an important step in pediatric
myringoplasty. Children with larger perforations, younger than 10 years
of age and having pathologic contralateral ear may have lower success
rates. The presence of these factors preoperatively should lead to the
consideration of more resistant (especially to retraction) graft
material such as tragal or conchal cartilage. |
