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DOI: 10.1055/s-0043-1776001
Pediatric Myringoplasty using the Periosteum: An Institutional Overview
Funding The author(s) received no financial support for the research.Abstract
Introduction Myringoplasty is a common otologic procedure to restore the integrity of the tympanic membrane in cases of traumatic or pathologic perforations. Many grafting materials have been used with different techniques.
Objective In the present work, we evaluate the surgical and audiological outcomes of periosteal graft overlying the mastoid cortex through a retroauricular incision in a pediatric cohort.
Methods A retrospective study was carried out involving all children aged ≤ 16 years who underwent periosteal graft myringoplasty for the treatment of chronic suppurative otitis media with dry central perforation in our hospital from April 2019 to April 2021. All patients were followed up for one year to assess the anatomical success and functional outcomes by comparing the preoperative and postoperative (after six months) results of pure tone audiometry (PTA).
Results The sample was composed of 36 patients; 20 of them were female (55.6%) and 16 were male (44.4%) subjects, with ages ranging from 7 to 16 (mean: 12.7) years. Four patients underwent surgery in both ears (with an interval of 6 to 9 months). Out of 40 surgeries performed, 38 ears have shown anatomical success (95%). A highly significant improvement in hearing was obtained (the mean difference between the pre- and postoperative results of the PTA was of 14.6 ± 3.45 dB (p < 0.001).
Conclusion We advocate the use of periosteal graft in the pediatric population as a good alternative for other types of grafts, with comparable and even better functional and anatomical outcomes.
Publication History
Received: 07 November 2022
Accepted: 25 June 2023
Article published online:
25 May 2024
© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
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References
- 1 Toynbee J. On the Use of an Artificial Tympanic Membrane in Causes of Deafness, Dependent Upon Perforation or Destruction of the Natural Organ. London: John Churchill; 1853
- 2 Glasscock III ME, Kanok MM. Tympanoplasty–a chronological history. Otolaryngol Clin North Am 1977; 10 (03) 469-477
- 3 Manolidis S. Closure of tympanic membrane perforations. In: Glasscock ME. editor. Glasscock-Shambaugh's Surgery of the Ear. 5th ed. Hamilton: BC Decker; 2003: 400-19
- 4 Sckolnick JS, Mantle B, Li J, Chi DH. Pediatric myringoplasty: factors that affect success-a retrospective study. Laryngoscope 2008; 118 (04) 723-729
- 5 Lee JC, Lee SR, Nam JK, Lee TH, Kwon JK. Comparison of different grafting techniques in type I tympanoplasty in cases of significant middle ear granulation. Otol Neurotol 2012; 33 (04) 586-590
- 6 Freitas MR, Oliveira TC. The role of different types of grafts in tympanoplasty. Rev Bras Otorrinolaringol (Engl Ed) 2014; 80 (04) 275-276
- 7 ElTaher M, Othman Y, Mohammed I, Ali K. Periosteal Graft Myringoplasty: Our Experience. Int Arch Otorhinolaryngol 2018; 22 (04) 374-377
- 8 Rao SSP, Prasad TVSSNL, Veeraswamy N, Vadlamani S. Comparative study on usage of temporalis fascia vs. periosteum in myringoplasty. J Evol Med Dent Sci 2016; 5 (35) 2068-2070
- 9 Mantsopoulos K, Thimsen V, Richter D. et al. Myringoplasty for pediatric chronic otitis media: An uncritical closure of a natural middle ear drainage?. Am J Otolaryngol 2021; 42 (06) 103122
- 10 Demirpehlivan IA, Onal K, Arslanoglu S, Songu M, Ciger E, Can N. Comparison of different tympanic membrane reconstruction techniques in type I tympanoplasty. Eur Arch Otorhinolaryngol 2011; 268 (03) 471-474
- 11 Chiossone E. Periosteal Grafting in Tympanoplasty: A Preliminary Report. Arch Otolaryngol 1964; 79: 302-311
- 12 Elmoursy MM, Elbahrawy MM. Comparative study of tympanoplasty type I using periosteum versus tragal cartilage with perichondrium. Egypt J Otolaryngol 2021; 35: 37-41
- 13 ElBatawi AM, ElTaher MA, Sabaa MAE. Tympanic membrane grafting, underlay periosteal versus inlay cartilage grafts: a comparative study. J Otolaryngol ENT Res 2018; 10 (05) 274-277
- 14 Tan HE, Santa Maria PL, Eikelboom RH, Anandacoomaraswamy KS, Atlas MD, Type I. Type I Tympanoplasty Meta-Analysis: A Single Variable Analysis. Otol Neurotol 2016; 37 (07) 838-846
- 15 Gonçalves AI, Rato C, Duarte D, de Vilhena D. Type I tympanoplasty in pediatric age - The results of a tertiary hospital. Int J Pediatr Otorhinolaryngol 2021; 150: 110899