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2019

ANUÁRIO DO HOSPITAL
DONA ESTEFÂNIA

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FAILURE OF TYMPANOPLASTY IN CHILDREN: PREDICTIVE FACTORS

Inês Moreira, Rita Ferreira, Ana Casas Novas, José Colaço, Luisa Monteiro.

Otorrinolaringologia, Hospital Dona Estefânia, Centro Hospitalar Lisboa Central, E.P.E.

- Congresso Anual da Sociedade Europeia de Otorrinolaringologia, Pediatrics Expo Amsterdam (Poster).

Objectives: To find predictive factors of failure of timpanoplasty in children.

Materials and Methods: Period study: 5 years. Inicial patient selection: 254 (patient clinical records codified as Simple Timpanoplasty - ICD: 9). Patients excluded: 161 (cole - steatoma/atelectasy; no clinical data available; follow up inferior to 6 months; childrens older than 15 years old). Final study population: 93. Comparative study between: surgical sucess grou p and the surgical failure group.

Results: (N=93) Age: 4 - 15 years old; average= 10 years old. Follow up: average= 24 months. Sucess group: 71% (N= 66), Failure Group: 29% (N=27). Reperfuration= 20 cases; Residual perfuration= 2 cases: Middles ear otitis with efusion= 3 cases; Atelectasy= 2 cases. The proportional rate of boys in the failure group was bigger and this is statistical significant (Pearson Qui-Square Test: r=0.1).
The contralateral ear condition was not different in the success and failure group (Pearson Qui-Square Test: 0.08). Other caracteristics of the failure group were: 50% of anterior perfurations, 38% of large perfurations; 43% of children with 4 to 7 years old; 42% with pre-surgical timpanometric volume inferior to 3.5 cc; and 34% of cases without associated mastoidectomy time.
The pre-surgical timpanometric volume (N=53) was 3.05 cc in the failure group, and 3.48 cc in the success group, and this was statistical significant (p=0.13)

Conclusions: Bad prognostic factors: male gender; anterior perfuration; large perfuration; children younger than 7 years old; timpanometric volume inferior to 3.5 cc. Some factors are age dependent but age alone in not a contraindication for treatment.

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