Retrospective long-term analysis of tympanoplasty in children

Objective: Tympanoplasty is a well-established surgical intervention for tympanic membrane perforation (TMP) in children, aiming to restore anatomical integrity and improve auditory function. However, long-term outcomes remain variable, and factors influencing surgical success are still debated. This study evaluates anatomical and functional outcomes of pediatric tympanoplasty over a five-year follow-up period, with a particular focus on the influence of age and other prognostic factors. Methods: A retrospective single-center cohort study was conducted at a tertiary referral hospital, including pediatric patients (<= 16 years) who underwent tympanoplasty for TMP between January 01, 2012 and December 31, 2022. Data were retrieved from electronic hospital records, including operative reports, audiometric evaluations, and follow-up documentation. Primary outcomes were anatomical success (intact tympanic membrane at follow-up) and functional success (air-bone gap <20 dB). Secondary outcomes included postoperative complications and factors influencing surgical success. Results: A total of 111 ears (96 patients) were analyzed, with a mean follow-up of 17.9 months (range 3-60 months). The overall anatomical success rate at five years was 57.9 % and functional success at five years was 69.4 %. No significant correlation between age and anatomical or functional outcomes was found, except at 12-months-follow-up, there was a statistically significant advantage for older patients in functional success. Perforation size and etiology significantly impacted success rates, with smaller and infection-related perforations demonstrating better outcomes. Conclusion: Tympanoplasty in children can result in favorable functional outcomes and moderate long-term anatomical success. No consistent age-related effect was observed, suggesting that surgical timing should be based on individual clinical factors rather than age alone. Perforation size and location as well as etiology emerged as more relevant prognostic factors. Future prospective multicenter studies are needed to validate these findings and guide patient selection.