Cartilage shield tympanoplasty in children: review of 268 consecutive cases. - Archive ouverte HAL Access content directly
Journal Articles Archives of Otorhinolaryngology - Head & Neck Surgery Year : 2011

Cartilage shield tympanoplasty in children: review of 268 consecutive cases.

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Abstract

OBJECTIVE: To assess the efficacy of partial ossicular chain reconstruction using autologous cartilage. DESIGN: Prospective study (April 1, 1997, through January 1, 2008). SETTING: Tertiary academic children's hospital. PATIENTS: Two hundred forty-eight children (268 ears) underwent partial ossicular chain reconstruction using a shaped block of tragal cartilage interposed between the head of the stapes and an underlay tympanic membrane reconstruction along with tragal cartilage and its perichondrium. MAIN OUTCOME MEASURES: Anatomical and audiologic results were evaluated according to the American Academy of Otolaryngology-Head and Neck Surgery guidelines. χ² Tests and multivariate analysis were used for statistical evaluation. RESULTS: Mean age at surgery was 10.9 years. Single-stage surgery was performed in 124 ears (46.3%) (62.9% for cholesteatomas and 32.3% for retraction pockets). Second-look patients (53.7%) included 93.8% of staged surgery. Audiometric results were available for 222 ears at 1 year and for 78 ears at 5 years. Closure of the average air-bone gap (ABG) to within 20 dB was achieved in 62.2% of ears at 1 year. The mean (SD) preoperative and 1-year postoperative ABGs were 25 (11.8) dB and 18.9 (10.3) dB, respectively. Anatomical results were satisfactory in 87.3%. No cases of extrusion, resorption, or displacement of the cartilage were encountered. No statistically significant difference was found between audiometric results at 1 and 5 years. Multivariate analysis showed a significant negative correlation between preoperative and postoperative ABGs and between postoperative otitis media with effusion and postoperative ABG (P < .05). CONCLUSIONS: Cartilage ossiculoplasty is a reliable technique for partial ossicular replacement. Long-term hearing outcomes remain stable and satisfactory. Preoperative ABG and postoperative otitis media are the predictive factors of the hearing outcome.

Dates and versions

inserm-00558570 , version 1 (22-01-2011)

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Jérôme Nevoux, Gilles Roger, Pierre Chauvin, Françoise Denoyelle, Erea Noel Garabédian. Cartilage shield tympanoplasty in children: review of 268 consecutive cases.. Archives of Otorhinolaryngology - Head & Neck Surgery, 2011, 137 (1), pp.24-9. ⟨10.1001/archoto.2010.229⟩. ⟨inserm-00558570⟩
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