Conclusion:
In this study, a large cohort of patients was reviewed, with a one-year
follow-up and with an identical surgical technique (underlay tragal
cartilage). We emphasise that, specifically in the child, success after
tympanic perforation surgery should be assessed in the long-run, with a
follow-up of at least one year for all patients, and should not only
focus on TM closure but also include the general aspect of the TM and
audiometric outcome. Our results tend to show that tympanic closure
should be best performed at the age of eight or older and that
myringitis is the most common long-term complication (5 to 9%).
Eustachian tube malfunction in the younger child seems to increase the
risk not only of tympanic closure failure, but also subsequent
cholesteatoma, retraction or OME. Due to the high success rate after
tympanoplasty for perforation in the child (80-90%), very large
prospective and multicentric studies are necessary to better identify
risk factors and the indications of different techniques (cartilage or
fascia grafts, underlay, overlay, butterfly, fat plug, etc.).