Role of Mastoid Exploration in Pediatric Tympanoplasty

Aim To determine the prognostic significance of “tympanometric volume” for pediatric tympanoplasty type I in a selected age group of 5 to 8 years as a parameter for mastoid surgery.

Materials and Methods A prospective study was conducted in 30 children with chronic suppurative otitis media-inactive mucosal disease of either sex. Preoperative tympanometric volume was recorded in all the cases and statistically analyzed with the graft uptake results postoperatively. All the patients underwent tympanoplasty type I by underlay technique using temporalis fascia graft. An intact graft at the end of 6 months, and a postoperative hearing improvement of 10 dB or greater in two consecutive frequencies, was regarded as surgical and audiological success, respectively. The statistical analysis was done using Mantel Haenszel x ², that is, Chi-square test, and Fisher's exact p-value test for confirmation.

Results We recorded an impressive surgical success rate of 87% and an audiological improvement of 70% in this study. On the basis of mean tympanometric volume of 1.6 cm3, the patients were divided into two groups: in group A (tympanometric volume < 1.6 cm³), and group B (tympanometric volume > 1.6 cm³). A graft uptake of 95 and 77% was recorded in groups A and B, respectively. However, the statistical evaluation of the data revealed no significant effect of this factor.

Conclusions In this study, no correlation between the tympanometric volume and the surgical success of pediatric tympanoplasty in selected age group of 5 to 8 years was observed. This implies that there is no distinct advantage of mastoid surgery in pediatric tympanoplasty.