The purpose of a tympanoplasty is to repair a hole in a tympanic membrane (TM). An important functional outcome of this surgery is to improve the hearing of the patient. It is a commonly held practice to abstain from tympanoplasty on children less than age four, with some physicians preferring to wait until the child is 6-8 years of age.
A recent study from Ejeah-Braimoh et al (2025) reviewed 111 ears of pediatric patients less than 16 years of age who had received tympanoplasty surgery (2012-2022). Data were collected and analyzed for anatomical success (TM still intact at follow up) and functional success (air/bone gap <20 dB). Follow-up documentation was also reviewed.
The anatomical success rate at five years was 57.9 percent, with the functional success rate at 69.4 percent. Interestingly, there was no significant correlation found between age and anatomical or functional outcomes. The size of the perforation as well as its etiology did significantly impact both anatomical and functional success; smaller and infection-related perforations had better outcomes.
The authors report no consistent relationship between age of patient and long-term outcomes and recommend that surgical timing be based on perforation size, location, and etiology.
Reference
Ejeah-Braimoh, O,, Baselt, B., & Röösli, C. (2025). Retrospective long-term analysis of tympanoplasty in children. International Journal of Pediatric Otorhinolaryngology, 196, 112474.
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