Introduction:
In children with tympanic membrane perforation, tympanoplasty aims to
reconstruct the tympanic membrane to allow swimming and to create a well
aerated, healthy, and hearing middle ear. Numerous surgical techniques
have been developed and various graft materials used for the closure of
tympanic membrane perforations, mainly fascia, fat, cartilage and
perichondrium. The increased frequency of upper respiratory tract
infections, otitis media, and eustachian tube dysfunction makes children
at higher risk of surgical failure after tympanoplasty compared to
adults (1).
Cartilage has become the preferential material for tympanic perforation
closure in the child, due to its resistance in unfavourable local
conditions, such as chronic infection or middle ear depression, which
are frequent in the child. These may immediately impede healing or occur
after closure and alter long-term results (2–5).
The importance of different factors and especially age at surgery
remains debated in the literature (6–12). Also, the tympanic closure
rate at 12 months follow-up or less does not seem sufficient to assess
the success of the procedure in paediatric patients, due to frequent
otitis media with effusion (OME) or post-operative retraction pockets or
cholesteatoma in children (7,9,11,13). Long-term success rate should
include tympanic closure without OME or post-operative complication and
audiological results (13,14).
The aim of the study was to determine the factors that could influence
the audiometric and functional results of cartilage tympanoplasty in
children with tympanic membrane perforation, in a large cohort of
children operated on with the same surgical procedure by paediatric
otologists. The secondary objective was to determine the long-term
three-year prognosis.