Myringoplasty in children: Our results

Abstract 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 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.