TYPE-1 TYMPANOPLASTY IN CHILDREN

Objective: To identify factors affecting the surgical success rate and reperforation rate in type 1 tympanoplasty. Controversy continues reg arding the advisability of this procedure in young children, largely b ecause of the likelihood of recurrent middle ear disease and eustachia n tube dysfunction. Design: Retrospective medical record review of a c ase 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 tymp anoplasties on 183 patients were included; 22 patients were excluded f or insufficient follow-up. Main Outcome Measures: Surgical success was defined by confirmation of an intact tympanic membrane at least 6 mon ths postoperatively. Procedures were deemed long-term successes if the tympanic membrane remained free of perforation to the end of follow-u p Results: The overall short-term surgical success rate was 92%, with 87% of ears remaining free of reperforation to the end of follow-up. I f the perforation involved the margin, the surgical success and long-t erm success rates dropped to 86% and 77%, respectively. Although reper foration 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: Tympano plasty may be considered at any age. Even in young children, there is a high likelihood of return to normal function.