Introduction. Perforation of the tympanic membrane in children may be the
cause of recurrent middle ear infection and loss of hearing. Objective. The
aim of this study was to analyze the application of different reconstructive
materials in surgical technique myringoplasty. Methods. We performed 88
myringoplasties due to auricular tragus perforation in 76 children (aged 4 to
16 years, mean 11.9 years) from July 2001 to July 2009. Age, gender, size and
the site of perforation, status of the contra lateral ear, underlying cause
of the perforations, surgical technique, preoperative and postoperative
hearing levels and postoperative complications were recorded and analyzed. In
performing myringoplasty we used fascia of the temporal muscle and cartilage
of the auricular tragus. Results. In 43 (48%) patients we used fascia of the
temporal muscle and in 45 (52%) cartilage of the auricular tragus. Graft
success was defined as an intact eardrum at 12 months postoperatively and
improvement in the perception of air-bone gap of 10 dB, which we recorded in
73 (83%) cases. Re-perforations were recorded in 12 (13%) patients, of whom
in 8 (18.6%) cases we used the temporal fascia and in 4 (9.3%) cases a tragal
cartilage. Retraction of the tympanic membrane was recorded in 3 (4%) cases
with the temporal fascia. Conclusion. Myringoplasty is a reasonably
successful method with good functional results in pediatric patients. Risk
factors of surgical failure are young age, the size of auricular tragus
perforation and pathological conditions of the contra lateral ear. The tragal
cartilage gives better results in cases with bilateral perforations because
the possibility of retractions and re-perforations is lower. Relatively small
number of patients is probably the reason that, except for young age,
differences between the two groups did not reach the level of statistical
significance.
Minimally invasive repair of ruptured Achilles tendon
