title: Outcomes of myringoplasty in Australian Aboriginal children and factors associated with success: a prospective case series.
abstract: The objective of this study was to assess the outcomes of myringoplasties in Aboriginal children and to identify factors associated with a successful outcome with the use of prospective case series from primary health care clinics and hospitals in four rural and remote regions of Western Australia. All 58 Aboriginal children, aged 5-15 years, who underwent 78 myringoplasties between 1 January 2000 and 30 June 2001 were included in the study. Complete postoperative (post-op) follow-up was achieved following 78% of myringoplasties. The main outcome measures were (a) success, i.e. an intact tympanic membrane and normal hearing six or more months post-op in the operated ear, (b) closure of the perforation, (c) Post-op hearing improvement. Forty-nine per cent of myringoplasties were successful, 72% resulted in closure or reduction in the size of the perforation and 51% resulted in hearing improvement. After controlling for age, sex, clustering and number of previous myringoplasties, no association was observed between success or hearing improvement and perforation size, or the presence of serous aural discharge at the time of surgery. Myringoplasty resulted in hearing improvement and/or perforation closure in a significant proportion of children. Thus, primary school-aged Aboriginal children in whom conservative management of chronic suppurative otitis media has been unsuccessful should have access to myringoplasty because of the positive impact on their socialization, language and learning that results from improved hearing.
authors.affiliation: Kimberley Public Health Unit, Derby, and School of Population Health, The University of Western Australia, Perth, Australia. makho@bigpond.com
authors.forename: D
authors.initials: D
authors.lastname: Mak
authors.forename: A
authors.initials: A
authors.lastname: MacKendrick
authors.forename: M
authors.initials: M
authors.lastname: Bulsara
authors.forename: H
authors.initials: H
authors.lastname: Coates
authors.forename: F
authors.initials: F
authors.lastname: Lannigan
authors.forename: D
authors.initials: D
authors.lastname: Lehmann
authors.forename: L
authors.initials: L
authors.lastname: Leidwinger
authors.forename: S
authors.initials: S
authors.lastname: Weeks
mesh_terms: D000158:Acoustic Impedance Tests; D000293:Adolescent; D017677:Age Distribution; D001315:Australia / Q000453:epidemiology; D002391:Catchment Area, Health; D002558:Cerebrospinal Fluid Otorrhea / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D034381:Hearing Loss / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D009225:Myringoplasty / Q000379:methods*; D010034:Otitis Media with Effusion / Q000208:ethnology* / Q000601:surgery*; D011184:Postoperative Period; D011446:Prospective Studies; D012424:Rural Population / Q000706:statistics & numerical data; D016896:Treatment Outcome