Learning Objectives: Paediatric tympanoplasty is a controversial subject with no consensus amoung otologists regarding the minimum age for the surgery. Moreover the subject does not find mention in standard text. There is a general tendency across the world to delay the said surgery on account of various factors like: eustachian tube maturity, size and site of perforation & age etc. I would be examining the concept of “Paediatric Tympanoplasty” in accordance with evidence based medicine: two prospective studies carried out at LHMC & Associated Hospitals, New Delhi. Our results indicate that the graft uptake in children is equal to adults and addresses the issue of deafness in children.
Objective: To evaluate the success rate of tympanoplasty type I in a select pediatric age group of 5 to 8 years, and thereby analyse the factors suggested to influence the outcome of the said surgery.
Study Design: A prospective study with control. 60 patients of chronic suppurative otitis media-inactive mucosal disease of either sex were divided into two groups of 30 each; Group A [paediatrics, 5–8years] and Group B [adults, >14 years]. All the patients underwent tympanoplasty type I by underlay technique using temporalis fascia graft. Pre-operative tympanometric volume was recorded in all the cases and analysed with the graft uptake results post-operatively. The data pertaining to surgical and audiological success was tabulated and statistically analysed.
Results: We recorded an impressive surgical success rate of 87% in Group A compared to a 90% success rate for group B. Also, an audiological success of 69% and 78% was recorded in the pediatric and adult group, respectively. Statistical analysis of the data revealed that age, status of the contralateral ear (taken as a measure of function of the Eustachian tube) and size of the perforation are not significant factors which might influence the outcome of paediatric tympanoplasty, but the site of the perforation was found to be a significant factor for the said surgery with anterior perforations recording a poor success rate. On the basis of mean tympanometric volume of 1.6cm3 the patients were divided into two groups: in Group A (tympanometric volume <1.6cm3), and group B (tympanometric volume >1.6cm3). A graft uptake of 95% and 77% was recorded in Group A & B respectively. However, the statistical evaluation of the data revealed no significant effect of this factor.
Conclusions: Tympanoplasty type I with underlay grafting using temporalis fascia in children aged between 5 to 8 years, gives good anatomical and functional results.
