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May 1994

Type 1 Tympanoplasty in Children

Author Affiliations

From the Department of Pediatric Otolaryngology, The Children's Hospital of Philadelphia and the University of Pennsylvania. Dr Kessler now practices pediatric otolaryngology in Ramat Gan, Israel.

Arch Otolaryngol Head Neck Surg. 1994;120(5):487-490. doi:10.1001/archotol.1994.01880290005001

Objective:  To identify factors affecting the surgical success rate and reperforation rate in type 1 tympanoplasty. Controversy continues regarding the advisability of this procedure in young children, largely because of the likelihood of recurrent middle ear disease and eustachian tube dysfunction.

Design:  Retrospective medical record review of a case series.

Setting:  Pediatric hospital that serves both as a primary care and referral center.

Patients:  All private patients younger than 18 years, undergoing type 1 tympanoplasty from 1985 through 1989, for whom at least 6 months' follow-up was available. Two hundred nine tympanoplasties on 183 patients were included; 22 patients were excluded for insufficient follow-up.

Main Outcome Measures:  Surgical success was defined by confirmation of an intact tympanic membrane at least 6 months postoperatively. Procedures were deemed long-term successes if the tympanic membrane remained free of perforation to the end of follow-up.

Results:  The overall short-term surgical success rate was 92%, with 87% of ears remaining free of reperforation to the end of follow-up. If the perforation involved the margin, the surgical success and long-term success rates dropped to 86% and 77%, respectively. Although reperforation was more likely in patients younger than 6 years or in those with contralateral otitis media at surgery, even these groups had long-term success rates of 81% and 74%, respectively.

Conclusions:  Tympanoplasty may be considered at any age. Even in young children, there is a high likelihood of return to normal function.(Arch Otolaryngol Head Neck Surg. 1994;120:487-490)

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