Tympanic Perforations in Children: When to Propose Surgical Closure?

Abstract

Objective: This study aims to analyze the impact of age and other prognostic factors on the success of myringoplasty.

Study design: A retrospective case series.

Settings: Pediatric ENT department of a tertiary academic center.

Patients: Two hundred forty-one children (318 ears) aged 3 to 17 years with tympanic perforation.

Intervention: Myringoplasty performed between 2009 and 2019.

Main outcomes measures: The rate of tympanic closure, perforation recurrence, revision surgery, and audiometric gain were collected. The impact of age and anatomical and surgical factors was analyzed for each procedure.

Results: With a mean follow-up time of 1 year, the tympanic closure rate was 87.7%, the perforation recurrence rate was 18.6%, and 16.7% of ears required reoperation. The mean air-bone gap decreased from 21 dB preoperatively to 12 dB postoperatively ( p < 0.0001). We did not find different anatomical and audiometric results for our three groups of patients classified according to age. Audiometric results were associated with the location of the perforation, intraoperative inflammation of the middle ear mucosa, and the surgical technique performed.

Conclusion: Myringoplasty in children is associated with excellent anatomical and functional results, even in the youngest patients. It can be proposed whatever the child's age if the patients are well selected before giving the indication.