Post-operative results after tympanoplasty with cartilage palisades in underlay technique in children.

OBJECTIVE

To evaluate anatomical and functional outcomes of type I tympanoplasty using 2-mm wide cartilage palisade grafts (CP) in children and to compare these outcomes with temporalis fascia (TF) and cartilage-perichondrium island grafts (CI).

METHODS

A retrospective cohort study was performed at a tertiary care center, including children aged 2-17 years who underwent type I tympanoplasty between January 2010 and December 2019. Outcomes were analyzed according to graft materials. Primary endpoints were rates of recurrent or residual tympanic membrane perforation and postoperative retraction. Secondary outcomes included changes in air-conduction thresholds (AC) and air-bone gap (ABG). Logistic regression was used to assess the influence of graft type and underlying pathology.

RESULTS

A total of 130 children (mean age 9.6 ± 3.8 years) were included (CP = 50, TF = 45, CI = 35). The CP group showed the lowest rates of postoperative perforation (16%) and retraction (4%) compared with TF (24.4%, 6.6%) and CI (20%, 5.7%) groups. Mean AC improvement was greatest in the CP group (8.9 dB; p < 0.001), followed by the CI group (5.4 dB; p < 0.001); improvement in the TF group was not significant. Reduction in ABG was greatest in the CP group (3.6 dB). Adhesive otitis media and cholesteatoma were significant predictors of postoperative perforation and retraction, respectively.

CONCLUSION

Type I tympanoplasty using 2-mm cartilage palisade grafts in children provides excellent graft stability and significant hearing improvement, even in high-risk middle ear conditions, supporting its use as a reliable pediatric reconstructive technique.