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Chatelet F, Leboulanger N, Achard S, Couloigner V, Denoyelle F, Simon F. Myringoplasty without tympanomeatal flap elevation in children: A systematic review. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 138:93-99. [PMID: 32888888 DOI: 10.1016/j.anorl.2020.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Systematic review of the literature on myringoplasty techniques without tympanomeatal flap elevation in children. MATERIAL AND METHODS A systematic review following PRISMA guidelines reported papers on patients under 18years of age undergoing myringoplasty for chronic tympanic perforation on a transcanal approach without tympanomeatal flap elevation. Tympanic closure rates and audiometric results were analyzed. RESULTS Twenty studies were included. Nine reported the butterfly technique, using a microscope or endoscope, with closure rate of 82.3% (246/299), for perforations of various sizes. Ten reported the fat-plug technique, with closure rate of 86.8% (869/1001), mostly for perforations of less than one-third of the tympanum. Both techniques improved audiometric results. Morbidity was very low. The absence of chronic otitis or co-morbidities (contralateral otitis media with effusion, craniofacial malformations, Down's syndrome) implies that patient selection technique may be necessary to obtain the best results. CONCLUSION Fat-plug myringoplasty, for small perforations, and butterfly cartilage myringoplasty seem to be reliable procedures in selected patients, with low morbidity in children.
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Affiliation(s)
- F Chatelet
- Service d'Oto-Rhino-Laryngologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, 149, rue de Sèvres, Paris, France.
| | - N Leboulanger
- Service d'Oto-Rhino-Laryngologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, 149, rue de Sèvres, Paris, France; Faculté de Médecine Paris Descartes, Université de Paris, Paris, France
| | - S Achard
- Service d'Oto-Rhino-Laryngologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, 149, rue de Sèvres, Paris, France
| | - V Couloigner
- Service d'Oto-Rhino-Laryngologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, 149, rue de Sèvres, Paris, France; Faculté de Médecine Paris Descartes, Université de Paris, Paris, France
| | - F Denoyelle
- Service d'Oto-Rhino-Laryngologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, 149, rue de Sèvres, Paris, France; Faculté de Médecine Paris Descartes, Université de Paris, Paris, France
| | - F Simon
- Service d'Oto-Rhino-Laryngologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, 149, rue de Sèvres, Paris, France; Faculté de Médecine Paris Descartes, Université de Paris, Paris, France
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