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Evidence summaries

Pediatric Tympanoplasty

Cartilage ossiculoplasty may be a reliable technique for partial ossicular replacement. Long-term hearing outcomes remain stable and satisfactory. Level of evidence: "C"

A prospective study 1 included 248 children (268 ears) for a partial ossicular chain reconstruction using autologous cartilage. Mean age at surgery was 10.9 years. Single-stage surgery was performed in 124 ears (46.3%) (62.9% for cholesteatomas and 32.3% for retraction pockets). Second-look patients (53.7%) included 93.8% of staged surgery. Closure of the average air-bone gap (ABG) to within 20 dB was achieved in 62.2% of ears at 1 year. The mean (SD) preoperative and 1-year postoperative ABGs were 25 (11.8) dB and 18.9 (10.3) dB, respectively. Anatomical results were satisfactory in 87.3%. No cases of extrusion, resorption, or displacement of the cartilage were encountered. No statistically significant difference was found between audiometric results at 1 and 5 years. Multivariate analysis showed a significant negative correlation between preoperative and postoperative ABGs and between postoperative otitis media with effusion and postoperative ABG (P < .05). Preoperative ABG and postoperative otitis media are the predictive factors of the hearing outcome.

    References

    • Nevoux J, Roger G, Chauvin P et al. Cartilage shield tympanoplasty in children: review of 268 consecutive cases. Arch Otolaryngol Head Neck Surg 2011;137(1):24-9. [PubMed]

Primary/Secondary Keywords