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Tympanoplasty in children younger than 10 years

Presenting Author: Riad Khnifies

Published online by Cambridge University Press:  03 June 2016

Riad Khnifies ,
Noam Yehudai  and
Michal Luntz
Riad Khnifies
Affiliation:
Bnai Zion Medical Center, Technion – The Bruce Rappaport Faculty of Medicine, Haifa, Israel
Noam Yehudai
Affiliation:
Bnai Zion Medical Center, Technion – The Bruce Rappaport Faculty of Medicine, Haifa, Israel
Michal Luntz
Affiliation:
Bnai Zion Medical Center, Technion – The Bruce Rappaport Faculty of Medicine, Haifa, Israel
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Abstract

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Learning objectives: to evaluate success rate of tympanoplasty in children younger than 10 years and to analyze indications for tympanoplasty in this age group

Introduction: Too often, and especially in children, tympanic membrane perforations are left open due to concerns regarding a possible non-optimal outcome related to frequent upper respiratory tract infections, persistent otitis media and ongoing middle ear underaeration syndrome. The aim of the study is to evaluate success rate of tympanoplasty in children younger than 10 years and to analyze indications for tympanoplasty in this age group.

Method: The study includes a group of 30 children who underwent tympanoplasty or tympanoplasty with canaloplasty between 2011 and 2013. All were younger than 10 years at the time of surgery.

Results: In 20 of the children the ear was dry prior to their referral for 6–12 months, in 10 there was a very large or enlarging perforation, and or high tendency to develop otorrhea with organism typical to chronic otitis media and not to acute otitis media and or bone conduction loss. 10 of the perforations were anterior perforations with overhanging anterior canal wall. In a follow up of 6 months -3 years after surgery, in 27 of the children the tympanic membrane was intact; in 3 children a tiny residual perforation was left. None of the children experienced an event of otitis media after surgery.

Conclusion: The success rate of tympanoplasty in children is relatively high, provided cases are properly selected and technic is carefully chosen (addition of canaloplasty whenever needed). The 10–15% of partial success or even failure (need for revision surgery) does not justify postponing tympanoplasty in all young children, exposing them to the consequences of a long standing tympanic membrane perforation.