Author(s)
R. Zaveri
S. R. Hoff
Affiliation(s)
Ann & Robert H. Lurie Children's Hospital Of Chicago & Northwestern University; University Of Illinois Medical Center
Abstract:
Objective: To describe our pediatric endoscopic tympanoplasty outcomes Setting: Tertiary Care Pediatric Hospital Methods: Retrospective review of pediatric patients undergoing endoscopic tympanoplasty by any method Results: 41 cases were performed in 38 ears (3 revisions). 4 patients had bilateral perforations, and in 3 of which both ears were repaired in the same sitting. All cases were performed transcanal endoscopically. Average age at surgery was 11.8 years (range 7-18 years). 18 (43.9%) of tympanoplasties used underlay grafts (facial, perichondrial, or tragal cartilage island), 2 (4.9%) lateral grafts, 17 (41.5%) cartilage inlay grafts (butterfly), 2 (4.9%) fat grafts, and 2 (4.9%) transtympanic with porcine intestinal graft. Size of perforation ranged from 10% to 95% subtotal. Perforation involved the anterior half of the tympanic membrane in 29 (70.7%) of cases. Average surgical time was 102 minutes for unilateral cases (range 18 – 281 minutes), and 148 minutes for bilateral concurrent cases (range 66 – 223 minutes). Residents and/or fellows were present in 33 (80.5%) of cases. Closure of perforation was successful in 34 (82.9%) of all cases, with the cartilage inlay butterfly graft having the highest success rate (95.0%). Average improvement of Pure Tone Average (PTA) was 14.8, and improvement of Air Bone Gap (ABG) was 12.5. There were no adverse events. Conclusion: The endoscopic transcanal approach for pediatric tympanoplasty offers comparable outcomes for successful graft take and improved hearing. Additionally, the endoscopes allow for superior visualization of anterior perforations, and a minimally invasive approach.