Longitudinal follow-up after pediatric myringoplasty: long-term outcome is defined at 12 months.

Objectives: To determine the true success rate of pediatric myringoplasty.
Materials and Methods: This retrospective study analyzed 67 pediatric myringoplasties performed at Hyogo College of Medicine between 2000 and 2009. We divided the pediatric population into a younger group (<10 yr old, n = 41) and an older group (≥10 yr old, n = 26). We also compared the pediatric group (n = 67) with a group of adult patients (n = 63) who underwent myringoplasty between 2008 and 2009.
Results: In the pediatric group, graft success was achieved in 81% of the cases. The pathologic success rate, which was based on the presence of an intact membrane without adhesion, retraction, or effusion, was 73%. Furthermore, an intact membrane with successful hearing was achieved in 67% of the cases at 12-month follow-up. The graft success rate of the adult group was 90%, and there was no significant difference with the pediatric group. However, when success was defined as pathologic success or pathologic success with hearing improvement, there were significant differences in success rates between pediatric and adults groups (p < 0.05). The success rate of pathologic success with hearing improvement was significantly lower in children with abnormal contralateral ears or poor contralateral air cell development than in children with healthy contralateral ears (p < 0.01) or good contralateral air cell development (p < 0.05).
Conclusion: These findings suggest that the success of pediatric myringoplasty should be defined as an intact tympanic membrane without evidence of adhesions, retraction, or effusion, together with hearing improvement at the 12-month follow-up.