ENTtoday
  • Home
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Multimedia
    • Video
    • Audio
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

What Is the Optimal Age to Repair Tympanic Membrane Perforations in Pediatric Patients?

by Marisa A. Ryan, MD, and David M. Kaylie, MD • June 20, 2017

  • Tweet
  • Email
Print-Friendly Version

TRIO Best PracticeTRIO Best Practice articles are brief, structured reviews designed to provide the busy clinician with a handy outline and reference for day-to-day clinical decision making. The ENTtoday summaries below include the Background and Best Practice sections of the original article. To view the complete Laryngoscope articles free of charge, visit Laryngoscope.com.

You Might Also Like

  • Is There an Optimal Location for Tympanostomy Tube Placement?
  • Does Concomitant Mastoidectomy Improve Outcomes for Tympanic Membrane Perforation Repair?
  • Best Practice in Tympanoplasty
  • Is Cartilage Preferable to Fascia Myringoplasty in Children?
Explore This Issue
June 2017

Background

Tympanic membrane perforation is a common pediatric otolaryngology diagnosis that most frequently occurs after myringotomy tube extrusion, complicated otitis media, or traumatic perforation. Repair is often necessary if it does not heal spontaneously. Untreated perforations can lead to conductive hearing loss, speech delays, chronic otorrhea, the need for precautions during water sports, and migration of squamous epithelium into the middle ear space where it can form cholesteatoma. Repair is typically performed with autologous fascia and/or cartilage grafts and can be described as a tympanoplasty or myringoplasty. The reported success of repair ranges from 35% to 94%, which is lower than in the adult population. The variability in criteria for surgical and audiologic success contributes to the wide range reported in the literature. Duration, size, and location of the perforation; status of the contralateral middle ear; Eustachian tube function; adenoid hypertrophy; and surgeon experience can all influence the outcome. Disagreement exists regarding the optimal age to repair tympanic membrane perforations and whether there is benefit to waiting until the child is past a certain age. Many different algorithms for timing repair have been proposed. The purpose of this study is to evaluate the literature to determine the optimal time to repair tympanic membrane perforations in the pediatric population.

Best Practice

Traumatic perforation of the tympanic membrane.

Traumatic perforation of the tympanic membrane.
© Michael Hawke, MD/Wikimedia Commons

Based on the available data, age does not appear to directly mediate the perforation closure, hearing, or complication outcomes after tympanic membrane perforation repair in pediatric patients. Other factors are indicative of outcome, such as underlying Eustachian tube function based on the presence of recurrent otitis media and the aeration of the contralateral middle ear space. Therefore, there should not be a minimum age cutoff for considering tympanic membrane repair. It should be recommended as soon as clinically appropriate for each child because experiencing a similar surgical outcome at a younger age results in substantial time, cost, and quality of life savings for the child and family. Standardizing reports of anatomical and audiological success in future studies could help further elucidate the benefits of not delaying repair (Laryngoscope. 2016;126:2201–2202).

Pages: 1 2 | Single Page

Filed Under: Pediatric, TRIO Best Practices Tagged With: outcome, patient care, pediatric, tympanic membrane perforationsIssue: June 2017

You Might Also Like:

  • Is There an Optimal Location for Tympanostomy Tube Placement?
  • Does Concomitant Mastoidectomy Improve Outcomes for Tympanic Membrane Perforation Repair?
  • Best Practice in Tympanoplasty
  • Is Cartilage Preferable to Fascia Myringoplasty in Children?

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • Is There a Crisis in the Otolaryngology Match?
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • New Developments in the Management of Eustachian Tube Dysfunction
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Vertigo in the Elderly: What Does It Mean?
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Post-Tonsillectomy Taste Disorders Rare but Present
    • 10 Novel Ways to Disseminate Scientific Information
    • How to Work with Sales and Marketing Representatives in Your Medical Practice
    • How Medicine Helped Surgeon Prepare for Career as Writer
    • Best Practices for Emergency Surgical Airway
    • Spare Roof Technique Can Improve Patient Quality of Life after Rhinoplasty

Polls

Will registry information and data science improve patient care?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2019 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.