Pediatric myringoplasty: does previous adenoidectomy improve the likelihood of perforation closure?

OBJECTIVE

To determine whether perforation closure after pediatric myringoplasty is more likely to be achieved in patients who have undergone a previous adenoidectomy and to evaluate the impact of other demographic and clinical parameters on operative success.

STUDY

DESIGN

Retrospective case review.

SETTING

: Teaching hospital.

PATIENTS: Children younger than 16 years.

INTERVENTION: Primary or revision myringoplasty undertaken between 1999 and 2007.

MAIN OUTCOME MEASURE: The integrity of the tympanic membrane was assessed by otoscopy or tympanometry during postoperative follow-up. Success was defined as an intact tympanic membrane with no evidence of middle ear disease.

RESULTS

Two hundred thirteen consecutive myringoplasties were performed. Patients' mean age was 12.1 years (range, 4-15 yr) and mean length of follow-up was 16 months (range, 2-99 mo). The overall perforation closure rate was 71.8%. The adenoidectomy group comprised 79 patients (37.1%). Perforation closure was achieved in 79.1% of these patients compared with 67.4% in the nonadenoidectomy group (p = 0.157). Older age (p = 0.032), smaller perforations (p = 0.042), nonanterior perforations (p = 0.022), and operations performed by a consultant (p = 0.047) all resulted in significantly higher rates of perforation closure.

CONCLUSION

This study suggests that adenoidectomy before pediatric myringoplasty may not improve the likelihood of a successful outcome.