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A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery
Indexed/Abstracted in: EMBASE, Scopus
Otorinolaringologia 2014 September;64(3):141-6
Follow-up after pediatric myringoplasty: outcome at 5 years
Ferrara S. 1, Salvago P. 1, Mucia M. 2, Ferrara P. 3, Sireci F. 1, Martines F. 1
1 Sezione di Otorinolaringoiatria, Dipartimento di Biomedicina Sperimentale e Neuroscienze Cliniche, (BioNeC), Università degli Studi di Palermo, Palermo, Italia;
2 Sezione di Audiologia, Dipartimento di Biopatologia e Biotecnologie Mediche e Forensi (Di.Bi.Me.F.), Università degli Studi di Palermo, Palermo, Italia;
3 Casa di Cura Macchiarella, Palermo, Italia
AIM: The aim of this paper was to evaluate anatomical and functional outcomes 5 years after myringoplasty in children affected by perforated eardrum. To analyze the main differences in the frequency of postoperative complications between patients under and over 9 years of age.
METHODS: One hundred and thirty-two children, aged from 4 to 15 years, who underwent myringoplasty with or without mastoidectomy, were followed for a five-year period after surgery. The cohort was divided in two groups: children from 4 to 9 years old (G1) and patients older than 9 years (G2); all subjects underwent a pre- and post-operatively clinical exam and were evaluated through audiometry and impedenzometry. Adenoidectomy, if necessary, was performed three months before myringoplasty.
RESULTS: Of the total 132 children of our cohort, the 32.58% were from 4 to 9 years old (G1) and the 67.42% were older than 9 years (G2). Twenty-five (58.13%) G1 and 2 (2.24%) G2 patients underwent adenoidectomy before myringoplasty (P<0.0001); in 18 (41.86%) G1 and 23 (25.84%) G2 subjects a mastoidetomy was associated to myringoplasty (P=0.062). The main postoperative complications observed were respectively retraction pockets (9.3%) and recurrent seromucous otitis (9.3%) in G1 group and myringosclerosis (4.4%) in G2 group. The GAP index (IG) resulted >2 (good-excellent degree) in the 89.36% of G1 and 91% of G2 children (P>0.5).
CONCLUSION: Nevertheless good audiologic outcomes in patients under and over 9 years of age, our study evidenced a different percentages of success after myringoplasty in G1 and G2 groups (P=0.0024). Thus, considering the higher percentage of postoperative complications in children with less than 9 years of age, myringoplasty should be considered cautiously due to the risk of reperforation and/or cholesteatoma.