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Pediatric myringoplasty: Prognostic factors in surgical outcome and hearing threshold recovery
Authors:A Sánchez Barrueco  D Lora Pablos  MA Villafruela Sanz  C Almodóvar Álvarez
Institution:1. Department of Otolaryngology, Hospital 12 de Octubre, Madrid, Spain;2. Clinical Research Unit, Clinical Trials, CIBERESP (imas12);3. Department of Otolaryngology, Children ENT Section, Hospital 12 de Octubre, Madrid, Spain
Abstract:Conclusions: This study shows as decisive factors the history of tympanostomy tube insertion and surgical approach. The closure of the perforation observed at the 6th post-operative month is almost definitive, without finding significant differences ahead. The myringoplasty can be performed simultaneously in bilateral perforations and in a day-case basis with same success rates. Astatistically significant audiometric improvement area is described, after myringoplasty, undescribed previously in literature. Objectives: The aim of this study was to evaluate prognostic factors in surgical outcome and hearing threshold after myringoplasty, in pediatric age. Methods: A 10-year retrospective review of 142 myringoplasties performed by a single surgeon of the Pediatric ENT Department of 12 de Octubre University Hospital. Multiple prognostic factors were investigated, such as those related to perforation and surgery, contralateral ear status, and pre- and post-operative hearing threshold. Results: The overall rate of closure of the perforation was 74.64%. The re-perforation rate was directly proportional to the number of tympanostomy tube insertion (OR = 1.64). Other determining factors were the surgical approach, the graft position and side. There was a post-operative significant improvement (p < 0.001) insuring that the more affected frequencies, low (125–500 Hz) and high frequencies (4000–8000 Hz), were the more improved after the procedure.
Keywords:Prognostic factors  hearing threshold  myringoplasty  tympanoplasty  pediatric  unique surgeon  tympanostomy tube  day-case basis  audiometric area
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