Pediatric Tympanoplasty: A 10-Year Experience

OBJECTIVES: To determine if the age of the child is a factor in healing after tympanoplasty and to find other factors that affect the outcome in these patients. DESIGN: Case series by retrospective otological chart review. SETTING: A group private practice otology and neuro-otology referral center. PATIENTS AND OTHER PARTICIPANTS: A consecutive sample of all patients younger than 20 years who had tympanoplasty performed at the House Ear Clinic between January 1, 1983, and January 1, 1993. The 318 patients, who had had 381 ears operated on, were separated into four age groups: younger than 7 years, 7 to 8 years, 9 to 12 years, and 13 to 19 years. The 268 patients who had follow-up examinations for 6 months or longer after tympanoplasty are grouped in the same age categories for outcomes analysis. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Preoperative and postoperative audiometric data and otologic examination at the final follow-up examination. Results are reported for hearing, healing, and "success," which combines hearing and healing and is defined as an intact graft with a postoperative air-bone gap of less than 25 dB. RESULTS: The operation resulted in an intact graft in 92.5% of ears and a postoperative air-bone gap less than 25 dB in 84% of ears. Success was achieved in 81% of ears. No difference in outcome was observed among the four age groups. Success was negatively affected by mastoidectomy, previous tympanoplasty, and use of total ossicular replacement prosthesis ossiculoplasty; perhaps by the number of previous myringotomy and tubes; but not by age, status of the contralateral ear, middle ear discharge, or fellow as primary surgeon. CONCLUSION: Tympanoplasty can be safely and effectively performed in children.