Myringoplasty in children: anatomic and functional results

Objectives: To evaluate the success rates of myringoplasty in children and to identify factors that could influence the surgical outcome. Methods: Myringoplasties performed on 55 children during the years 2000-2005 with at least 18 months follow-up period were retrospectively reviewed. The mean age of the patients was 12.4 (range 8-16 years). Surgical success was defined as having an intact, mobile graft without atelectasis and having an air-bone gap under 20 dB after 18 months postoperatively. Factors that could influence the surgical outcome such as age, status of the opposite ear, perforation size and experience of the surgeon were also investigated. Results: The overall graft success rate 18 months postoperatively was 72.7%. The mean values of preoperative and postoperative air-bone gaps were 26.4 +/- 2.6 dB vs 10.5 +/- 9.2 dB respectively. This result was statistically significant (p<0.001). Perforation size greater than 75% of the tympanic membrane area was found to be a negative prognostic factor (p=0.023). The success rates were also found to be low in younger children with pathologic contralateral ear although the results were not in the range of significance. Conclusion: Myringoplasty in children gives good anatomic and functional results. However, one must always keep in mind that the patient evaluation preoperatively is an important step in pediatric myringoplasty. Children with larger perforations, younger than 10 years of age and having pathologic contralateral ear may have lower success rates. The presence of these factors preoperatively should lead to the consideration of more resistant (especially to retraction) graft material such as tragal or conchal cartilage.