Department of Otorhinolaryngology, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy; Department of Otorhinolaryngology, Head and Neck Surgery, Meyer Children's Hospital, Florence, Italy.
Department of Otorhinolaryngology, Head and Neck Surgery, Meyer Children's Hospital, Florence, Italy.
Int J Pediatr Otorhinolaryngol. 2022 Sep;160:111246. doi: 10.1016/j.ijporl.2022.111246. Epub 2022 Jul 14.
Myringoplasty is a frequently performed procedure in children, with a heterogeneous failure rate. Our study aimed to evaluate the outcome of myringoplasty in a pediatric hospital and to identify which are risk factors for reperforation or poor hearing improvement after surgery.
Preoperative and intraoperative variables between pediatric patients who had undergone myringoplasty with an intact tympanic membrane at follow-up and the cases with reperforation were compared. The same factors were investigated as potential predictors of audiological success. Pre and postoperative PTA and ABG were compared in the whole population, in structural success and failure groups and closure of ABG was calculated and used to compare the audiological outcomes between the two groups.
Parameters that affected the postoperative integrity of TM were age, the time between diagnosis and surgery, the intraoperative status of the middle ear, and secondhand smoke exposure. Early perforations occurred mostly after surgeries performed by trainees, while late perforations were more frequently in autumn. Myringoplasty, regardless of the structural outcome, can improve the ABG and PTA. No preoperative and intraoperative parameters affected the audiological outcome.
Pediatric myringoplasty is a safe and successful procedure that can improve hearing, regardless of the structural outcome. In light of our results, parameters to consider before surgery are age, the time between diagnosis and surgery, the intraoperative status of the middle ear, and secondhand smoke exposure.
鼓室成形术在儿童中是一种经常施行的手术，其失败率存在差异。本研究旨在评估儿童医院鼓室成形术的结果，并确定哪些是术后再穿孔或听力改善不佳的危险因素。
比较在随访时鼓膜完整的接受鼓室成形术的儿科患者与再穿孔病例之间的术前和术中变量。研究了相同的因素作为听力成功的潜在预测因子。在整个人群、结构成功和失败组中比较了术前和术后 PTA 和 ABG，并计算了 ABG 的闭合程度，并用于比较两组之间的听力结果。
影响术后鼓膜完整性的参数是年龄、诊断与手术之间的时间、中耳术中状态和二手烟暴露。早期穿孔多发生在由受训者进行的手术后，而晚期穿孔则更常见于秋季。鼓室成形术，无论结构结果如何，都可以改善 ABG 和 PTA。术前和术中的参数均未影响听力结果。
儿童鼓室成形术是一种安全且成功的手术，可以改善听力，无论结构结果如何。根据我们的结果，手术前需要考虑的参数是年龄、诊断与手术之间的时间、中耳术中状态和二手烟暴露。
