Ejeah-Braimoh Osikhe, Baselt Bastian, Röösli Christof
Universitätsspital Zürich, Klinik für Ohren-, Nasen-, Hals- und Gesichtschirurgie, Frauenklinikstrasse 24, 8091, Zurich, Switzerland.
Int J Pediatr Otorhinolaryngol. 2025 Sep;196:112474. doi: 10.1016/j.ijporl.2025.112474. Epub 2025 Jul 7.
Tympanoplasty is a well-established surgical intervention for tympanic membrane perforation (TMP) in children, aiming to restore anatomical integrity and improve auditory function. However, long-term outcomes remain variable, and factors influencing surgical success are still debated. This study evaluates anatomical and functional outcomes of pediatric tympanoplasty over a five-year follow-up period, with a particular focus on the influence of age and other prognostic factors.
A retrospective single-center cohort study was conducted at a tertiary referral hospital, including pediatric patients (≤16 years) who underwent tympanoplasty for TMP between January 01, 2012 and December 31, 2022. Data were retrieved from electronic hospital records, including operative reports, audiometric evaluations, and follow-up documentation. Primary outcomes were anatomical success (intact tympanic membrane at follow-up) and functional success (air-bone gap <20 dB). Secondary outcomes included postoperative complications and factors influencing surgical success.
A total of 111 ears (96 patients) were analyzed, with a mean follow-up of 17.9 months (range 3-60 months). The overall anatomical success rate at five years was 57.9 % and functional success at five years was 69.4 %. No significant correlation between age and anatomical or functional outcomes was found, except at 12-months-follow-up, there was a statistically significant advantage for older patients in functional success. Perforation size and etiology significantly impacted success rates, with smaller and infection-related perforations demonstrating better outcomes.
Tympanoplasty in children can result in favorable functional outcomes and moderate long-term anatomical success. No consistent age-related effect was observed, suggesting that surgical timing should be based on individual clinical factors rather than age alone. Perforation size and location as well as etiology emerged as more relevant prognostic factors. Future prospective multicenter studies are needed to validate these findings and guide patient selection.
鼓室成形术是治疗儿童鼓膜穿孔（TMP）的一种成熟的外科干预措施，旨在恢复解剖结构完整性并改善听觉功能。然而，长期疗效仍存在差异，影响手术成功的因素仍存在争议。本研究评估了儿童鼓室成形术在五年随访期内的解剖和功能结局，特别关注年龄及其他预后因素的影响。
在一家三级转诊医院进行了一项回顾性单中心队列研究，纳入2012年1月1日至2022年12月31日期间因TMP接受鼓室成形术的儿科患者（≤16岁）。数据从电子医院记录中获取，包括手术报告、听力评估和随访记录。主要结局为解剖学成功（随访时鼓膜完整）和功能学成功（气骨导差<20dB）。次要结局包括术后并发症及影响手术成功的因素。
共分析了111只耳（96例患者），平均随访17.9个月（范围3 - 60个月）。五年时的总体解剖学成功率为57.9%，功能学成功率为69.4%。未发现年龄与解剖或功能结局之间存在显著相关性，但在12个月随访时，年龄较大的患者在功能学成功方面具有统计学上的显著优势。穿孔大小和病因对成功率有显著影响，较小的穿孔及与感染相关的穿孔显示出更好的结局。
儿童鼓室成形术可带来良好的功能结局和中等程度的长期解剖学成功。未观察到与年龄相关的一致影响，这表明手术时机应基于个体临床因素而非仅基于年龄。穿孔大小、位置以及病因是更相关的预后因素。未来需要进行前瞻性多中心研究以验证这些发现并指导患者选择。
