Specific aspects of tympanoplasty in children: A retrospective cohort study of 95 cases

BACKGROUND: Paediatric tympanoplasty is now a common surgical procedure. The age from which it could be proposed varies regarding children specificities such as Eustachian tube dysfunction, the high incidence of upper airway infections and the immaturity of the immune system. The aim of this study is to describe the specific constitutional, epidemiological and operative aspects as well as the anatomical and functional results of tympanoplasty in children. METHODS: From 2014 to 2018, a cohort of 95 patients with ages between 6 and 16 years, operated for a type I tympanoplasty, was reviewed by analysing the medical history, the epidemiological and clinical parameters, in addition to the operative features and the functional results. RESULTS: The mean age at surgery was 11,7 years. The main risk factors of tympanic perforation were recurrent otitis (78,9%), auricular trauma (16,8%) and tonsillar and adenoid hypertrophy (7,4%). Good anatomical postoperative results with a closed and reinforced neo-tympanic membrane were seen in 90 (94,7%) cases, while a significant improvement of the hearing loss was observed in 87 (91.6%) patients, with a mean value of 34,23 dB HL before and 21,9 dB HL after surgery (p < 0,0001). CONCLUSIONS: The indications of type I tympanoplasty in the paediatric population remain a subject of debate, but still offer good anatomical and functional results as long as it is adapted to each particular case.