Skip to main content
Top
Published in: BMC Pediatrics 1/2018

Open Access 01-12-2018 | Research article

Type 1 tympanoplasty in pediatric patients: a review of 102 cases

Authors: Deniz Baklaci, Ismail Guler, Ihsan Kuzucu, Rauf Oguzhan Kum, Muge Ozcan

Published in: BMC Pediatrics | Issue 1/2018

Login to get access

Abstract

Background

The aim of this study was to investigate the success of type 1 tympanoplasty in pediatric patients with chronic otitis media, and to evaluate the prognostic factors that may influence its success.

Materials and methods

Medical records of 102 children aged between 8 and 18 years (46 female, 56 male) who underwent type 1 tympanoplasty for chronic tympanic membrane perforation between January 2010 and July 2017 were reviewed. Age, gender, condition of contralateral ear (unilateral, bilateral), type (central, marginal) and location of perforation (anterior, posterior, inferior), graft material (fascia, cartilage), pre- and post-operative hearing levels, mean air-bone gap (ABG), surgical approach (postauricular, endaural) and length of follow up were recorded.

Results

Anatomical and functional success (ABG < 20 dBHL) rates were 86.3% (88 patients) and 74.5% (76 patients) after a mean follow-up of 32 ± 16.55 months, respectively. The mean hearing improvement was 10.77 ± 10.45 dBHL. The graft success rates were significantly higher in tragal cartilage group (95.1%) than in temporalis fascia group (80.3%) (p = 0.033). Graft success was negatively affected by contralateral perforation (p = 0.003). All patients with bilateral perforations and graft failure were in temporalis fascia group. Age, type and location of perforation and surgical approach did not influence graft success (p > 0.05).

Conclusion

Our results showed that type 1 tympanoplasty can be performed effectively in pediatric population regardless of age, location and type of perforation and surgical approach. Bilateral perforations are prone to reperforation, and should be treated with cartilage graft.
Literature
1.
go back to reference Wullstein H. Theory and practice of tympanoplasty. Laryngoscope. 1956;66(8):1076–93.CrossRef Wullstein H. Theory and practice of tympanoplasty. Laryngoscope. 1956;66(8):1076–93.CrossRef
3.
go back to reference Pyman C. Signposts to successful tympanoplasty, With special reference to children. J Otolaryngol Soc Aust. 1964;1:233–47.PubMed Pyman C. Signposts to successful tympanoplasty, With special reference to children. J Otolaryngol Soc Aust. 1964;1:233–47.PubMed
4.
go back to reference Lau T, Tos M. Tympanoplasty in children. An analysis of late results. Am J Otol. 1986;7(1):55–9.CrossRef Lau T, Tos M. Tympanoplasty in children. An analysis of late results. Am J Otol. 1986;7(1):55–9.CrossRef
5.
go back to reference Kessler A, Potsic WP, Marsh RR. Type 1 tympanoplasty in children. Arch Otolaryngol Head Neck Surg. 1994;120(5):487–90.CrossRef Kessler A, Potsic WP, Marsh RR. Type 1 tympanoplasty in children. Arch Otolaryngol Head Neck Surg. 1994;120(5):487–90.CrossRef
6.
go back to reference Bluestone CD, Cantekin EI, Douglas GS. Eustachian tube function related to the results of tympanoplasty in children. Laryngoscope. 1979;89(3):450-8.CrossRef Bluestone CD, Cantekin EI, Douglas GS. Eustachian tube function related to the results of tympanoplasty in children. Laryngoscope. 1979;89(3):450-8.CrossRef
7.
8.
go back to reference Raine C, Singh S. Tympanoplasty in children: a review of 472 cases. Ann Otol Rhinol Laryngol. 1980;89:331–4.CrossRef Raine C, Singh S. Tympanoplasty in children: a review of 472 cases. Ann Otol Rhinol Laryngol. 1980;89:331–4.CrossRef
9.
go back to reference Koch WM, Friedman EM, McGill TJ, Healy GB. Tympanoplasty in children: the Boston Children's Hospital experience. Arch Otolaryngol Head Neck Surg. 1990;116(1):35–40.CrossRef Koch WM, Friedman EM, McGill TJ, Healy GB. Tympanoplasty in children: the Boston Children's Hospital experience. Arch Otolaryngol Head Neck Surg. 1990;116(1):35–40.CrossRef
10.
go back to reference Shih L, de Tar T, Crabtree JA. Myringoplasty in children. Otolaryngol Head Neck Surg. 1991;105(1):74–7.CrossRef Shih L, de Tar T, Crabtree JA. Myringoplasty in children. Otolaryngol Head Neck Surg. 1991;105(1):74–7.CrossRef
11.
go back to reference Lancaster J, Makura Z, Porter G, McCormick M. Paediatric tympanoplasty. J Laryngol Otol. 1999;113(7):628–32.CrossRef Lancaster J, Makura Z, Porter G, McCormick M. Paediatric tympanoplasty. J Laryngol Otol. 1999;113(7):628–32.CrossRef
12.
go back to reference Caylan R, Titiz A, Falcioni M, De Donato G, Russo A, Taibah A, et al. Myringoplasty in children: factors influencing surgical outcome. Otolaryngol Head Neck Surg. 1998;118(5):709–13.PubMed Caylan R, Titiz A, Falcioni M, De Donato G, Russo A, Taibah A, et al. Myringoplasty in children: factors influencing surgical outcome. Otolaryngol Head Neck Surg. 1998;118(5):709–13.PubMed
13.
go back to reference Collins WO, Telischi FF, Balkany TJ, Buchman CA. Pediatric tympanoplasty: effect of contralateral ear status on outcomes. Arch Otolaryngol Head Neck Surg. 2003;129(6):646–51.CrossRef Collins WO, Telischi FF, Balkany TJ, Buchman CA. Pediatric tympanoplasty: effect of contralateral ear status on outcomes. Arch Otolaryngol Head Neck Surg. 2003;129(6):646–51.CrossRef
14.
go back to reference Rapin I. Conductive hearing loss effects on children's language and scholastic skills: a review of the literature. Ann Otol Rhinol Laryngol. 1979;88(5_suppl):3–12.CrossRef Rapin I. Conductive hearing loss effects on children's language and scholastic skills: a review of the literature. Ann Otol Rhinol Laryngol. 1979;88(5_suppl):3–12.CrossRef
15.
go back to reference Schuknecht HF. Cholesteatoma. Pathology of the Ear. 2nd ed. Philadelphia: Lea & Febiger; 1993. p. 204–206. Schuknecht HF. Cholesteatoma. Pathology of the Ear. 2nd ed. Philadelphia: Lea & Febiger; 1993. p. 204–206.
16.
go back to reference Manning SC, Cantekin EI, Kenna MA, Bluestone CD. Prognostic value of eustachian tube function in pediatric tympanoplasty. Laryngoscope. 1987;97(9):1012–6.CrossRef Manning SC, Cantekin EI, Kenna MA, Bluestone CD. Prognostic value of eustachian tube function in pediatric tympanoplasty. Laryngoscope. 1987;97(9):1012–6.CrossRef
17.
go back to reference Panel SA. Referral to pediatric surgical specialists. Pediatrics. 2014;133(2):350–6.CrossRef Panel SA. Referral to pediatric surgical specialists. Pediatrics. 2014;133(2):350–6.CrossRef
18.
go back to reference Balkany TA, Gates GA, Goldenberg RA, Meyerhoff WL, House JW, SURG OHN. Committee on hearing and equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss. Otolaryngol Head Neck Surg. 1995;113(3):186–7.CrossRef Balkany TA, Gates GA, Goldenberg RA, Meyerhoff WL, House JW, SURG OHN. Committee on hearing and equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss. Otolaryngol Head Neck Surg. 1995;113(3):186–7.CrossRef
19.
go back to reference Bylander A, Tjernström Ö. Changes in Eustachian tube function with age in children with Normal ears: a Longiudinal study. Acta Otolaryngol. 1983;96(5–6):467–77.CrossRef Bylander A, Tjernström Ö. Changes in Eustachian tube function with age in children with Normal ears: a Longiudinal study. Acta Otolaryngol. 1983;96(5–6):467–77.CrossRef
20.
go back to reference Glasscock ME. Symposium: contraindications to tympanoplasty: II. An exercise in clinical judgment. Laryngoscope. 1976;86(1):70–6.CrossRef Glasscock ME. Symposium: contraindications to tympanoplasty: II. An exercise in clinical judgment. Laryngoscope. 1976;86(1):70–6.CrossRef
21.
go back to reference MacDonald RR, Lusk RP, Muntz HR. Fasciaform myringoplasty in children. Arch Otolaryngol Head Neck Surg. 1994;120(2):138–43.CrossRef MacDonald RR, Lusk RP, Muntz HR. Fasciaform myringoplasty in children. Arch Otolaryngol Head Neck Surg. 1994;120(2):138–43.CrossRef
22.
go back to reference Carr MM, Poje CP, Nagy ML, Pizzuto MP, Brodsky LS. Success rates in paediatric tympanoplasty. J Otolaryngol Head Neck Surg. 2001;30(4):199. Carr MM, Poje CP, Nagy ML, Pizzuto MP, Brodsky LS. Success rates in paediatric tympanoplasty. J Otolaryngol Head Neck Surg. 2001;30(4):199.
23.
go back to reference Rodrigues J, Sousa AC, Gomes A, Gomes P, Mexedo A, Fonseca R. Type I Tympanoplasty in adolescence: prognostic factors and surgical outcomes. Small. 2017;25(16):30.8. Rodrigues J, Sousa AC, Gomes A, Gomes P, Mexedo A, Fonseca R. Type I Tympanoplasty in adolescence: prognostic factors and surgical outcomes. Small. 2017;25(16):30.8.
24.
go back to reference Kumar S, Acharya A, Hadjihannas E, Panagamuwa C, McDermott AL. Pediatric myringoplasty: definition of “success” and factors affecting outcome. Otol Neurotol. 2010;31(9):1417–20.PubMed Kumar S, Acharya A, Hadjihannas E, Panagamuwa C, McDermott AL. Pediatric myringoplasty: definition of “success” and factors affecting outcome. Otol Neurotol. 2010;31(9):1417–20.PubMed
25.
go back to reference Castro O, Pérez-Carro AM, Ibarra I, Hamdan M, Meléndez JM, Araujo A, et al. Myringoplasties in children: our results. Acta Otorrinolaringol (English Edition). 2013;64(2):87–91.CrossRef Castro O, Pérez-Carro AM, Ibarra I, Hamdan M, Meléndez JM, Araujo A, et al. Myringoplasties in children: our results. Acta Otorrinolaringol (English Edition). 2013;64(2):87–91.CrossRef
26.
go back to reference Rozendorn N, Wolf M, Yakirevich A, Shapira Y, Carmel E. Myringoplasty in children. Int J Pediatr Otorhinolaryngol. 2016;90:245–50.CrossRef Rozendorn N, Wolf M, Yakirevich A, Shapira Y, Carmel E. Myringoplasty in children. Int J Pediatr Otorhinolaryngol. 2016;90:245–50.CrossRef
27.
go back to reference Ozbek C, Çiftçi O, Tuna EEU, Yazkan Ö, Ozdem C. A comparison of cartilage palisades and fascia in type 1 tympanoplasty in children: anatomic and functional results. Otol Neurotol. 2008;29(5):679–83.CrossRef Ozbek C, Çiftçi O, Tuna EEU, Yazkan Ö, Ozdem C. A comparison of cartilage palisades and fascia in type 1 tympanoplasty in children: anatomic and functional results. Otol Neurotol. 2008;29(5):679–83.CrossRef
28.
go back to reference Halim A, Borgstein J. Pediatric myringoplasty: postaural versus transmeatal approach. Int J Pediatr Otorhinolaryngol. 2009;73(11):1580–3.CrossRef Halim A, Borgstein J. Pediatric myringoplasty: postaural versus transmeatal approach. Int J Pediatr Otorhinolaryngol. 2009;73(11):1580–3.CrossRef
Metadata
Title
Type 1 tympanoplasty in pediatric patients: a review of 102 cases
Authors
Deniz Baklaci
Ismail Guler
Ihsan Kuzucu
Rauf Oguzhan Kum
Muge Ozcan
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2018
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-018-1326-1

Other articles of this Issue 1/2018

BMC Pediatrics 1/2018 Go to the issue