Abstract
Objectives: The aim of the study was to identify factors that could
influence the repair of eardrum perforation using cartilage graft (or
cartilage tympanoplasty) in children.
Methods: A cohort of children operated on between January 1998 and
December 2012 was reviewed. We have studied the repair rate of the
eardrum (anatomical result) and the hearing level with audiometric tests
(functional result) at 1 year and 3 years after surgery. These results
were correlated with size or location of the perforation, status of the
contralateral ear, gender, allergies, cleft palate, craniofacial
anomalies, expertise of the surgeon (junior, senior) and perioperative
observations (mucosa, glue, etc.).
Results: 1240 tympanoplasties were
selected from the database, of which 139 ears (127 patients) could be
analysed (perforation without concurrent disease, authorisation from
patients obtained and sufficient information reported). Mean age at
surgery was 9.6 years ± 2.6 (range 4-16). At one year, 129/139 (93%)
tympanic membranes were closed and 112/139 (81%) were satisfactory (no
residual perforation, nor retraction, cholesteatoma, myringitis or OME).
Air-bone gap was < 20 dB in 102/127 ears (80%). At 3 years,
the eardrum was closed in 64/66 (97%) ears (reperforation in one case)
and 82% were satisfactory. Myringitis occurred in 5% and 9% of cases
at one- and three-year follow-up. Surgery before the age of 8 years was
the only risk factor of a non-satisfactory result at one-year follow-up
(p = 0.024).
Conclusions: Long-term results were satisfactory; the only risk factor
was surgery before eight years of age. In the child, long-term yearly
follow-up is necessary after tympanic perforation.
Keywords: tympanoplasty; perforation; cartilage; child,
pediatric, paediatric