Pediatric myringoplasty: factors that affect success-a retrospective study.
OBJECTIVE
To evaluate the impact of patient and graft variables on the successful closure of tympanic membrane perforations treated with myringoplasty at the Children's Hospital of Pittsburgh from 2000 to 2005.


METHODS
Retrospective chart review at an academic tertiary-care children's hospital.


METHODS
Charts were reviewed for 604 children, ages 1 to 18 years old, with complete records who underwent myringoplasty by the pediatric otolaryngology practice at Children's Hospital of Pittsburgh of UPMC from 2000 to 2005, totaling 777 procedures.


RESULTS
Significant variables include patient age, number of prior tubes, perforation etiology (P < .000), presence of a retained tube (P < .000) as well as tube type (P = .016), graft material (P = .001), and history of Down syndrome (P = .035). Nonsignificant variables include season of procedure (P = .599), status of adenoid tissue (P = .910), prior otorrhea (P = .175), as well as perforation location (P = .318) and duration (P = .150).


CONCLUSIONS
Proper patient and graft material selection can affect the outcome of myringoplasty procedures. Practical implications from these data suggest that Gelfoam myringoplasty is more successful than either paper patch or fat graft closures, with a 90.8% success rate (P = .001). Myringoplasty should not be deferred during the winter months as the season of procedure does appear to not affect the success of closure (P = .60). Similarly, the presence or absence of adenoid tissue did not affect the success of closure (P = .91).
Sckolnick
Joshua S
JS
Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Mantle
Belinda
B
Li
Jia
J
Chi
David H
DH
D000234:Adenoids / Q000473:pathology; D000273:Adipose Tissue / Q000637:transplantation; D000293:Adolescent; D000367:Age Factors; D001672:Biocompatible Materials / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004314:Down Syndrome / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D008876:Middle Ear Ventilation / Q000295:instrumentation; D009225:Myringoplasty / Q000379:methods*; D010033:Otitis Media / Q000150:complications; D010209:Paper; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D018058:Tympanic Membrane Perforation / Q000209:etiology / Q000601:surgery*
D001672:Biocompatible Materials