Myringoplasty in children: Our results

Introduction: Tympanoplasty is a surgical operation involving the repair of the tympanic membrane without any ossicular chain damage. Objective: To analyze prognostic factors influencing the success of myringoplasty in children under 17 years. Method: We present a retrospective study (2000–2011) reviewing a total of 63 children between 7 and 16 years who had undergone a primary tympanoplasty which was bilateral in 7 cases. Anatomical success was defined as an intact graft at the last follow-up visit with a minimum of 6 months. Hearing success was considered if the post-operative air bone gap (ABG) was less than 10 dB calculated on 500 Hz, 1000 Hz and 2000 Hz. Results: We recorded 70 operated ears. The mean age was 14.25 years [7–16] with a sex-ratio of 0.52. The perforation was subtotal in most cases (31.4%). We used conchal cartilage graft in 20%, tragus cartilage in 27% and temporalis fascia in 53%. Postoperatively, perforation closure was observed in 92.8% (n = 65) and hearing improvement in 65%. We obtained better audiological and anatomical results with conchal graft (85% and 100% respectively) compared with tragus cartilage and temporalis fascia without a statistically significant difference. Significant factors influencing surgical outcome were age older than 12 years (p = 0.02), absence of allergic rhinitis (p < 0.001), dry middle ear (p = 0.001), preoperative conductive hearing loss (p = 0.04) and placement of the graft under the malleus handle (p = 0.04). Conclusion: Myringoplasty is a valid treatment for tympanic membrane perforation in pediatric population. If performed properly, it has a good chance of restoring a child’s hearing