Long-term results and prognostic factors of underlay myringoplasty in pars tensa atelectasis in children.

IMPORTANCE

Pars tensa retraction is a frequent condition in chronic otitis media, and there is a large diversity of opinions regarding its management.

OBJECTIVE

To report the long-term results and prognostic factors of myringoplasty in pediatric patients with grade 5 pars tensa atelectasis.

DESIGN, SETTING, AND

PARTICIPANTS

This was an observational, retrospective case review, conducted at a referral university hospital, of children undergoing surgical intervention for dry tympanic disruption after a clinical history of tensa retraction with a transcanal or postauricular approach under general anesthesia.

INTERVENTIONS: Underlay myringoplasty with temporalis fascia or tragal perichondrium by transcanal or postauricular approach under general anesthesia.

MAIN OUTCOMES AND MEASURES: Anatomical results are reported with a minimum follow-up of 5 years analyzing perforation or retraction of the neotympanum. Age; sex; side, position, and size of the eardrum disruption; surgical approach; graft material; and presence of contralateral disease were correlated with anatomical failure.

RESULTS

The population included 33 girls and 28 boys undergoing 65 interventions; the age varied from 4 to 16 years (mean [SD], 10 [3.2] years). An intact tympanic membrane was obtained in 58 cases (89.2%) with a follow-up varying from 5 to 14 years (mean follow-up, 9 years). None of the variables analyzed significantly predisposed patients to tympanic perforation after surgical repair. There were no new progressive retractions.

CONCLUSIONS AND RELEVANCE: Tensa retraction resulting in a tympanic disruption can be cured by underlay myringoplasty with perichondrium or temporalis fascia with results similar to those of simple tympanic perforations without recurrent retraction even in the long-term period.