Reasons for reperforation after tympanoplasty in children

In 116 children and 124 cars with non-cholestratomatous chronic otitis medi a operated on during a 13-year period from 1968 to 1980 via transcanal tymp anoplasty and followed with several re-evaluations 15-27 years after operat ion, the causes of reperforation have been analysed. In total, 14 ears (11% ) had reperforation; in 7 ears (5.6%), the reperforations occurred early (d uring the first 3 months) and in 7 ears late (after 6 months), but most oft en the reperforations occurred after 10 years. The early reperforations wer e presumably Failures in surgery. Less experienced surgeons and inflamed, w et middle car mucosa during the primary surgery seemed to be the two most i mportant causal factors. Young age at surgery, size and site of the perfora tion acid Eustachian tube function seemed to be of no importance for reperf oration. The early reperforations were closed at surgery and remained close d into adulthood. The reasons for late reperforations are less clear: they were presumably caused by acute otitis media with perforation in an atrophi c part of the drum, which did not heal. The reperforations were small, but it was possible to close all of them surgically if the patients wanted to b e reoperated. It is concluded that tympanoplasty, even in young children, i s a rewarding option with good and stable results.