Outcome of myringoplasty and type 1 tympanoplasty in children: a systematic review and meta-analysis.

OBJECTIVE

To evaluate the anatomical and audiological outcomes of myringoplasty and type I tympanoplasty in the pediatric population through systemic review and meta-analysis.

METHOD: A systematic search of PubMed, Scopus, Web of Science and Cochrane Library databases was conducted for studies published between January 2021 until September 2025. Studies involving patients ≤ 18 years undergoing myringoplasty or type 1 tympanoplasty were included. Random-effects meta-analysis was performed to estimate pooled proportions of tympanic membrane closure and postoperative complications, as well as pooled mean air-bone gap (ABG) improvement. Heterogeneity, publication bias, sensitivity analyses, subgroup analyses, and meta-regression were performed. The risk of bias of studies was evaluated using JBI Critical Appraisal Checklist and categorizing them into low, moderated or high risk of bias according to methodological constraints.

RESULT: Thirty-eight studies comprising 4658 ears were included. The pooled tympanic membrane closure rate was 85.8% (95% CI: 83.3 to 88.3), with substantial heterogeneity (I² = 81.0%). The pooled rates of postoperative infection, keratin pearl formation, and recurrent perforation rates were 11.6%, 4.0%, and 11.5%, respectively. The pooled mean postoperative air-bone gap (ABG) gain was 11.18 dB (95% CI: 9.55 to 12.81). Subgroup analysis demonstrated significantly higher success rates in studies with higher risk of bias.

CONCLUSION

Myringoplasty and type 1 tympanoplasty in children demonstrate high anatomical success rates and meaningful hearing improvement with relatively low complication rates. However, substantial heterogeneity and variability in study design warrant cautious interpretation of these findings.