Objectives: This study aimed to determine surgical outcome of tympanoplasty
in children with iatrogenic perforations, to determine whether age is a fa
ctor in successful tympanoplasty, and to determine whether surgical outcome
is affected by preoperative factors (e.g., perforation size and location,
otorrhea, cholesteatoma, and tympanosclerosis) or surgical technique (e.g.,
underlay or overlay).
Study Design: The study design was a retrospective series review.
Setting: The study was conducted at a multiphysician private otologic pract
ice.
Patients: Ninety-three pediatric patients with iatrogenic perforations caus
ed by the insertion of ventilation tubes for otitis media with effusion (OM
E) participated. Surgical selection criteria included a year's observation
of the perforation with a 6-month OME-free interval in the involved and con
tralateral ear. The 46 males and 47 females had a mean age at surgery of 10
.8 years (standard deviation = 2.9) ranging from 3-16 years.
Interventions: All patients underwent underlay or overlay tympanoplasty usi
ng temporalis fascia grafts.
Main Outcome Measures: Outcome was evaluated in terms of drum healing (heal
ed or perforated), hearing (air-bone gap), and complications. l
Results: There was a graft take-rate of 94.6% with reperforations occurring
in 5.4% with an average follow-up of 16.8 months. Duration of follow-up ra
nged from 10.8-77.5 months. The air-bone gap was completely closed in 53.8%
and was closed to within 10 dB in 80.7% and 20 dB in 94.7%. The incidence
of major and minor complications Was 16.1%. Surgical outcome was not influe
nced by age, technique, or any of the preoperative factors.
Conclusions: Tympanoplasty of persistent perforations after ventilation tub
e therapy for recurrent OME can be performed successfully regardless of age
, surgical technique, or other preoperative factors.