Identification of predictors of anatomical and functional success in pediatric type I tympanoplasty.

In this case control study, we reviewed the medical records of children undergoing type I tympanoplasty between January 2012 and December 2022 in our hospital. Anatomical success was evaluated at 6 (T1), 12 (T2) months and at the end of follow up (T3). Functional success was defined as a mean postoperative ABG < 10 dB in ears with sustained tympanic membrane integrity.

A total of 79 ears (67 patients) were included. The median age of our sample was 12 years (range, 8–17), and the median follow-up period was 27 months (range, 12–86). The anatomical success rates at T1, T2, and T3 were 88.6%, 83.5%, and 77.2%, respectively. The etiology of the perforation was an independent predictor of anatomical success at T2 and T3. Patients with traumatic or post-ventilation tube perforations were less likely to experience reperforation compared with those with chronic otitis media ( P = 0.023 and P = 0.009, respectively). The presence of tympanosclerosis was an independent predictor of reperforation at T1, T2, and T3. The mean postoperative ABG was 6.45 ± 0.91 dB HL. Larger tympanic membrane perforations ( > 50% of the total TM area) had significant worse functional outcomes ( P = 0.021).

Type I tympanoplasty has good anatomical and functional outcomes in the pediatric age. The etiology of the perforation and the presence of tympanosclerosis may be used as predictors of anatomical success. Larger perforations may predict worse postoperative audiometric outcomes.