title: Pediatric myringoplasty: does previous adenoidectomy improve the likelihood of perforation closure?
abstract: OBJECTIVE
  To determine whether perforation closure after pediatric myringoplasty is more likely to be achieved in patients who have undergone a previous adenoidectomy and to evaluate the impact of other demographic and clinical parameters on operative success.
  
  
  METHODS
  Retrospective case review.
  
  
  METHODS
  : Teaching hospital.
  
  
  METHODS
  Children younger than 16 years.
  
  
  METHODS
  Primary or revision myringoplasty undertaken between 1999 and 2007.
  
  
  METHODS
  The integrity of the tympanic membrane was assessed by otoscopy or tympanometry during postoperative follow-up. Success was defined as an intact tympanic membrane with no evidence of middle ear disease.
  
  
  RESULTS
  Two hundred thirteen consecutive myringoplasties were performed. Patients' mean age was 12.1 years (range, 4-15 yr) and mean length of follow-up was 16 months (range, 2-99 mo). The overall perforation closure rate was 71.8%. The adenoidectomy group comprised 79 patients (37.1%). Perforation closure was achieved in 79.1% of these patients compared with 67.4% in the nonadenoidectomy group (p = 0.157). Older age (p = 0.032), smaller perforations (p = 0.042), nonanterior perforations (p = 0.022), and operations performed by a consultant (p = 0.047) all resulted in significantly higher rates of perforation closure.
  
  
  CONCLUSIONS
  This study suggests that adenoidectomy before pediatric myringoplasty may not improve the likelihood of a successful outcome.
authors.affiliation: Department of Otolaryngology, Leeds General Infirmary, Leeds, UK. sdcharlett@doctors.org.uk
authors.forename: Simon D
authors.initials: SD
authors.lastname: Charlett
authors.forename: Lindsay C
authors.initials: LC
authors.lastname: Knight
mesh_terms: D000233:Adenoidectomy; D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D009225:Myringoplasty; D010034:Otitis Media with Effusion / Q000150:complications / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000473:pathology / Q000601:surgery; D018058:Tympanic Membrane Perforation / Q000209:etiology / Q000473:pathology / Q000601:surgery*