AN ANALYSIS OF THE RESULTS OF MYRINGOPLASTY IN CHILDREN

An analysis of the results of 100 temporalis fascia underlay myringopl asties in children between the ages of 2-17 years is presented. The fo llow-up period in this retrospective review was from 6 to 24 months. T here was no statistically significant correlation between the age of p atient, a history of previous ear surgery, previous general anaesthesi a, previous adenotonsillar surgery, preoperative otorrhoea, impaired e ustachian tubal function, individual surgeon performing the surgery, s ize of perforation or operative technique and the outcome of the surge ry with respect to graft take rate. The overall graft take rate was 75 .3% of the 93 patients that returned for follow-up. The seniority of t he surgeon and by implication the degree of operative experience of th e surgeon is found to be significantly correlated with the graft take rate (P < 0.05). On audiometric testing, the mean pre-operative air co nduction threshold improved significantly (P < 0.0001) from 32.0 dBHL (S.D. 11.22) to 20.18 dBHL (S.D. 15.54) while the speech reception thr eshold improved from a mean of 25.34 dBHL (S.D. 12.88) to 18.79 (S.D. 15.5) (P < 0.0005). Although not statistically significant, patients u nder the age of 8 years were found to have a low graft take rate (56%) when compared to the mean. The audiometric results in this age group were comparable to the rest of the group. The findings in this study s uggest that myringoplasty is a beneficial procedure in the pediatric p opulation in the hands of a skilled and experienced surgeon. The learn ing curve seen in the surgeons in this study suggests that suitable ca ses for junior surgeons should be carefully selected.